Organization
ORAL SURGERY ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUY K. JENSEN DDS, MS (ORAL SURGEON)
(920) 923-0111
Entity
Organization
Contact information
Practice address
2100 GATEWAY CT, SUITE 101, WEST BEND, WI 53095-8550
(262) 335-2282
(262) 335-2296
Mailing address
2100 GATEWAY CT., SUITE 101, WEST BEND, WI 53095-8556
(262) 335-2282
(262) 335-2296
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2787-15
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5000111-15
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5001856-15
WI
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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