Great Lakes Oral & Maxillofacial Surgery, PA
Great Lakes Oral & Maxillofacial Surgery, PA is an Oral and Maxillofacial Surgery (Dentist) in Hudson, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2010.
- Licensed in
- WI
- In the registry since
- 2010
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1200 Crest View Dr Ste 1Hudson, WI 54016-9391
Phone: (715) 381-7070
Fax: (715) 381-0383
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Oral and Maxillofacial Surgery (Dentist) (primary) | Taxonomy 1223S0112X · Licence 4482 (WI) |
|---|
Record details
| NPI number | 1902116288 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Richard Brunton — President · (651) 351-1010 |
| NPI enumerated | October 20, 2010 |
| Last updated in NPPES | October 20, 2010 |
| Mailing address | 1200 Crest View Dr Ste 1, Hudson, WI 54016-9391 |