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Organization
ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES OF WAUKESHA, LTD.
Active
Organization
ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES OF WAUKESHA, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY STEPHEN NOVAK D.D.S. (PRESIDENT)
(262) 547-8665
Entity
Organization
Contact information
Practice address
1111 DELAFIELD ST, SUITE 222, WAUKESHA, WI 53188-3403
(262) 547-8665
(262) 547-4328
Mailing address
1111 DELAFIELD ST, SUITE 222, WAUKESHA, WI 53188-3403
(262) 547-8665
(262) 547-4328
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/25/2006
Last updated
08/21/2012
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