Organization
ORAL SURGERY CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERICH HERBST DDS (PRESIDENT)
(608) 356-2112
Entity
Organization
Contact information
Practice address
1203 8TH ST, BARABOO, WI 53913-1805
(608) 356-2112
(608) 356-0919
Mailing address
1203 8TH ST, BARABOO, WI 53913-1805
(608) 356-2112
(608) 356-0919
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38382200
—
WI
01
—
518579
DEANCARE PROVIDER #
—
Enumeration date
02/20/2007
Last updated
08/22/2020
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