# ORAL SURGERY ASSOCIATES LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235466988
- **Authorized official:** DR. GUY K. JENSEN DDS, MS (ORAL SURGEON)
- **Authorized official phone:** (920) 923-0111

## Contact information

- **Practice address:** 2100 GATEWAY CT, SUITE 101, WEST BEND, WI 53095-8550
- **Practice address phone:** (262) 335-2282
- **Practice address fax:** (262) 335-2296
- **Mailing address:** 2100 GATEWAY CT., SUITE 101, WEST BEND, WI 53095-8556
- **Mailing address phone:** (262) 335-2282
- **Mailing address fax:** (262) 335-2296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2787-15 | WI | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5000111-15 | WI | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5001856-15 | WI | Yes |

## Other

- **Enumeration date:** 11/17/2009
- **Last updated:** 11/17/2009