# WAUSAU ORAL SURGERY AND DENTAL IMPLANT CENTER, SC

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

## Provider details

- **NPI number:** 1497202386
- **Authorized official:** DR. PARIMAL SAPOVADIA DMD (ORAL SURGEON/PRESIDENT)
- **Authorized official phone:** (715) 845-4511

## Contact information

- **Practice address:** 3000 WESTHILL DR, SUITE 301, WAUSAU, WI 54401-3795
- **Practice address phone:** (715) 845-4511
- **Practice address fax:** (715) 845-1898
- **Mailing address:** 3000 WESTHILL DR, SUITE 301, WAUSAU, WI 54401-3795
- **Mailing address phone:** (715) 845-4511
- **Mailing address fax:** (715) 845-1898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5943-15 | WI | Yes |

## Other

- **Enumeration date:** 09/08/2016
- **Last updated:** 09/08/2016