Wisconsin Oral & Maxillofacial Surgery LLC

NPI #1013409002 in Oak Creek, Wisconsin

Provider Information

NPI Number: 1013409002
Entity Type: Organization
Organization Name: Wisconsin Oral & Maxillofacial Surgery LLC
Primary Specialty: Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date: Jun 5, 2018
Last Updated: Jun 5, 2018

Practice Location

Address: 2603 W RAWSON AVE STE 123
City: Oak Creek
State: Wisconsin
ZIP Code: 53154-8422
Phone: (914) 325-5672

Authorized Official

Name: DR. EJLAL ALALAWI, DMD
Title: OWNER/PROVIDER
Phone: (914) 325-5672

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X
Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	261QS0112X	Primary

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