Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Elmbrook Oral & Maxillofacial Surgery Assoc , SC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1366586224

Elmbrook Oral & Maxillofacial Surgery Assoc , SC is an Oral and Maxillofacial Surgery (Dentist) in Brookfield, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007

Practice location Address checks out

12720 W North Ave
Brookfield, WI 53005-4637
Phone: (262) 784-0053
Fax: (262) 784-0757
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 4138-015 (WI)

Record details

NPI number1366586224
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Wallock — President · (262) 784-0053
NPI enumeratedFebruary 16, 2007
Last updated in NPPESAugust 22, 2020
Mailing address12720 W North Ave, Brookfield, WI 53005-4637

Other providers in Brookfield