Great Lakes Oral & Maxillofacial Surgery, P.a.
NPI #1205136074 in New Richmond, Wisconsin
Provider Information
- NPI Number
- 1205136074
- Entity Type
- Organization
- Organization Name
- Great Lakes Oral & Maxillofacial Surgery, P.a.
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Oct 27, 2010
- Last Updated
- Oct 27, 2010
Practice Location
- Address
- 227 MERIDIAN DR # 6
- City
- New Richmond
- State
- Wisconsin
- ZIP Code
- 54017-2565
- Phone
- (715) 246-5150
Authorized Official
- Name
- MRS. CONNIE LOUISE MILLER
- Title
- PRACTICE MANAGER
- Phone
- (651) 351-1010
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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