Sheboygan Oral And Maxillofacial Assoc Ltd

LBN: Sheboygan Oral And Maxillofacial Assoc Ltd
Sheboygan Oral And Maxillofacial Assoc Ltd is an health care organization with primary practice located at .3637 Wilgus Avenue , Sheboygan WI 53081. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Sheboygan Oral And Maxillofacial Assoc Ltd can be contacted via phone (920) 458-8213, or through Keller, John Jay via phone (920) 458-8213.

Contact Information

Primary practice address
.3637 Wilgus Avenue Sheboygan WI 53081
Phone: (920) 458-8213
Fax: (920) 459-9797
Website:
Map and Directions
Authorized official contact:
Name: Keller, John Jay Doctor of Dental Surgery (DDS)
Phone: (920) 458-8213

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X

Profile Details

NPI number 1306894134
LBN Legal business name Sheboygan Oral And Maxillofacial Assoc Ltd
DBA Doing business as
Authorized official Keller, John Jay Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2006
Last updated Jan 21st, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306894134 NPPES
Wisconsin MEDICAID 38365300

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