| NPI | 1316954928 |
|---|---|
| Former Legal Business Name | ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES OF EAU CLAIRE SC |
| Entity Type | Organization |
| Authorized Contact | GINA K THOR Transcription And Credentialing 715-834-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: WI 4495-015) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: WI 4680-015) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: WI 5112-015) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: WI 5563-015) | |
| 1223E0200X Dentist, Endodontics | |
| 1223E0200X Dentist, Endodontics (Licence: WI 6222-15) | |
| 1223E0200X Dentist, Endodontics (Licence: WI 4412-015) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2018-07-26 |