Organization
ORAL & MAXILLOFACIAL SURGERY CONSULTANTS OF WISCONSIN, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD HENRY NELLEN DDS (PRESIDENT)
(414) 281-3344
Entity
Organization
Contact information
Practice address
4811 S 76TH ST, SUITE 304, GREENFIELD, WI 53220-4364
(414) 281-3344
(414) 281-1080
Mailing address
4811 S 76TH ST, SUITE 304, GREENFIELD, WI 53220-4364
(414) 281-3344
(414) 281-1080
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2699
WI
Other
Enumeration date
07/30/2006
Last updated
08/22/2020
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