GREAT LAKES ORAL & MAXILLOFACIAL SURGERY, P.A. is an oral and maxillofacial surgery dentist in New Richmond, WI. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. GREAT LAKES ORAL & MAXILLOFACIAL SURGERY, P.A. NPI is 1205136074. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
227 MERIDIAN DR # 6 NEW RICHMOND, WI ZIP 54017-565 Phone: (715) 246-5150 Fax: (715) 246-5102
The provider's authorized official is Connie Louise Miller . The authorized official title is Practice Manager and has the following contact phone number (651) 351-1010.
The enumeration date for this NPI number is 10/27/2010 and was last updated on 10/27/2010.
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:
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: 3/30/2025
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