Organization
ASSOCIATED ORAL & MAXILLOFACIAL SURGEONS SC
Active
Parent organization
ASSOCIATED ORAL AND MAXILLOFACIAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASSOCIATED ORAL AND MAXILLOFACIAL
Authorized official
DR. TERRENCE JOHN RIESCH DDS (PRESIDENT)
(262) 253-6588
Entity
Organization
Contact information
Practice address
N89 W16785 APPLETON AVE, MENOMONEE FALLS, WI 53051
(262) 253-6588
(262) 253-6893
Mailing address
N89 W16785 APPLETON AVE, MENOMONEE FALLS, WI 53051
(262) 253-6588
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4287
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4287
WI
Other
Enumeration date
12/13/2007
Last updated
06/06/2008
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