Kenosha Oral Surgery, SC
Kenosha Oral Surgery, SC is an Oral and Maxillofacial Surgery (Dentist) in Kenosha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.
- Licensed in
- WI
- In the registry since
- 2007
Practice location Address checks out
6707 39th AveKenosha, WI 53142-7125
Phone: (262) 658-3559
Fax: (262) 658-0276
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 4998015 (WI) |
|---|
Record details
| NPI number | 1710160486 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Dale Willoughby — President · (262) 658-3559 |
| NPI enumerated | December 17, 2007 |
| Last updated in NPPES | June 2, 2022 |
| Certification date | June 2, 2022 |
| Mailing address | 4707 Washington Rd, Kenosha, WI 53144-1597 |
Other providers in Kenosha
-
Gregory A. Santarelli DDS SC
5017 Green Bay Rd Ste 138, Kenosha, WI 53144-1782 · (262) 654-6770
-
Gregory A. Santarelli, DDSSC
5017 Green Bay Rd Ste 138, Kenosha, WI 53144-1782 · (262) 654-6770
-
Dale Wayne Willoughby, DDS
6707 39th Ave, Kenosha, WI 53142-7125 · (262) 658-3559