# ORAL SURGERY ASSOCIATES OF WISCONSIN, S.C.

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

## Provider details

- **NPI number:** 1700280963
- **Authorized official:** JEFFREY R LANG DDS (PRESIDENT)
- **Authorized official phone:** (920) 725-5584

## Contact information

- **Practice address:** 1155 WITTMANN DR, MENASHA, WI 54952-3607
- **Practice address phone:** (920) 725-5584
- **Practice address fax:** (920) 725-0160
- **Mailing address:** 1155 WITTMANN DR, MENASHA, WI 54952-3607
- **Mailing address phone:** (920) 725-5584
- **Mailing address fax:** (920) 725-0160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2014
- **Last updated:** 10/17/2014