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BAYCARE CLINIC LLP NPI 1174732572


NPI Information

NPI: 1174732572
Provider Name: BAYCARE CLINIC LLP
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Organization

CLIA Number: 52D2090130

Address:
2581 DEVELOPMENT DR
GREEN BAY, WI
ZIP 54311
Phone: (920) 347-0400
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BAYCARE CLINIC LLP is an oral maxillofacial surgery in Green Bay, WI. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. BAYCARE CLINIC LLP NPI is 1174732572. The provider is registered as an organization entity type.

The provider's business location address is:

2581 DEVELOPMENT DR
GREEN BAY, WI
ZIP 54311-247
Phone: (920) 347-0400
Fax: (920) 347-0868

The provider's authorized official is Chris Jay Augustine .
The authorized official title is Chief Executive Officer and has the following contact phone number (920) 405-5382.

The CLIA number assigned to this NPI record is 52D2090130 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 4/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2204E00000XOral & Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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