# WISCONSIN ORAL SURGERY & DENTAL IMPLANTS, S.C.

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

## Provider details

- **NPI number:** 1760538490
- **Authorized official:** DR. ANTHONY L RAGONESE DDS (PRESIDENT)
- **Authorized official phone:** (414) 327-4130

## Contact information

- **Practice address:** 10401 W LINCOLN AVE, SUITE 101, WEST ALLIS, WI 53227-1255
- **Practice address phone:** (414) 327-4130
- **Practice address fax:** (414) 327-4218
- **Mailing address:** 10401 W LINCOLN AVE, SUITE 101, WEST ALLIS, WI 53227-1255
- **Mailing address phone:** (414) 327-4130
- **Mailing address fax:** (414) 327-4218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5420-015 | WI | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 03/29/2021