| Bay Oral Surgery & Implant Center, Ltd | |
|
2353 S Ridge Road Green Bay WI 54304 | |
| (920) 499-0471 | |
| (920) 499-8312 |
| Full Name | Bay Oral Surgery & Implant Center, Ltd |
|---|---|
| Speciality | Dentist |
| Location | 2353 S Ridge Road, Green Bay, Wisconsin |
| Authorized Official Name and Position | Ellen M Greene (PRACTICE ADMINSTRAT) |
| Authorized Official Contact | 9204990471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Oral Surgery & Implant Center, Ltd 2353 S Ridge Road Green Bay WI 54304 Ph: (920) 499-0471 | Bay Oral Surgery & Implant Center, Ltd 2353 S Ridge Road Green Bay WI 54304 Ph: (920) 499-0471 |
| NPI Number | 1427270776 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 12/16/2014 |
| Medicare PECOS PAC ID | 0446274708 |
|---|---|
| Medicare Enrollment ID | O20060125000689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427270776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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