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Organization
ORAL SURGERY ASSOCIATES LTD
Active
Organization
ORAL SURGERY ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUY K. JENSEN DDS, MS (ORAL SURGEON)
(920) 923-0111
Entity
Organization
Contact information
Practice address
2100 GATEWAY CT, SUITE 101, WEST BEND, WI 53095-8550
(262) 335-2282
(262) 335-2296
Mailing address
2100 GATEWAY CT., SUITE 101, WEST BEND, WI 53095-8556
(262) 335-2282
(262) 335-2296
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2787-15
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5000111-15
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5001856-15
WI
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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