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Organization

CENTRAL WISCONSIN ORAL AND FACIAL SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAULETTE WRIGHT (MANAGER)
(843) 525-0900
Entity
Organization

Contact information

Practice address
438 EDISON ST, ANTIGO, WI 54409-1845
(715) 432-4565
Mailing address
968 RIBAUT RD STE 3, BEAUFORT, SC 29902-8002
(843) 525-0900
(843) 525-0380

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5831-15
WI

Other

Enumeration date
10/26/2017
Last updated
10/26/2017
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