Organization
MADISON ORAL & MAXILLOFACIAL SURGEONS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY G STRONCEK DDS (TREASURER)
(608) 274-0770
Entity
Organization
Contact information
Practice address
5801 RESEARCH PARK BLVD, STE 110, MADISON, WI 53719-6002
(608) 274-7711
(608) 274-9224
Mailing address
5801 RESEARCH PARK BLVD, STE 110, MADISON, WI 53719-6002
(608) 274-7711
(608) 274-9224
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38358100
—
WI
01
—
407050
DEAN HEALTH PLAN GROUP
WI
Enumeration date
06/09/2006
Last updated
08/22/2020
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