Northwoods Oral and Maxillofacial Surgery Sc

NPI #1346460441 in Minocqua, Wisconsin

Provider Information

NPI Number: 1346460441
Entity Type: Organization
Organization Name: Northwoods Oral and Maxillofacial Surgery Sc
Primary Specialty: Dentist
Enumeration Date: Apr 30, 2007
Last Updated: Sep 17, 2007

Practice Location

Address: 9762 WEST LAKE AVENUE
City: Minocqua
State: Wisconsin
ZIP Code: 54548
Phone: (715) 358-3321

Authorized Official

Name: JOHN MICHAEL KOSMEN, DDS
Title: DENTIST
Phone: (715) 358-3321

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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