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

Lake Geneva Oral and Maxillofacial Surgery, Ltd

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1063420206

Lake Geneva Oral and Maxillofacial Surgery, Ltd is an Oral and Maxillofacial Surgery (Dentist) in Lake Geneva, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

312 Center St
Lake Geneva, WI 53147-1904
Phone: (262) 248-8766
Fax: (262) 248-6790
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X (WI)

Record details

NPI number1063420206
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adam Ozment — President · (262) 248-8766
NPI enumeratedAugust 3, 2006
Last updated in NPPESJuly 21, 2022
Mailing address312 Center St, Lake Geneva, WI 53147-1904

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