| Oral Surgery Center, S.c. | |
|
1203 8th St Baraboo WI 53913-1805 | |
| (608) 356-2112 | |
| (608) 356-0919 |
| Full Name | Oral Surgery Center, S.c. |
|---|---|
| Speciality | Dentist |
| Location | 1203 8th St, Baraboo, Wisconsin |
| Authorized Official Name and Position | Erich Herbst (PRESIDENT) |
| Authorized Official Contact | 6083562112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Surgery Center, S.c. 1203 8th St Baraboo WI 53913-1805 Ph: (608) 356-2112 | Oral Surgery Center, S.c. 1203 8th St Baraboo WI 53913-1805 Ph: (608) 356-2112 |
| NPI Number | 1245374362 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0042301665 |
|---|---|
| Medicare Enrollment ID | O20070810000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245374362 | NPI | - | NPPES |
| 38382200 | Medicaid | WI | |
| 518579 | Other | DEANCARE PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Steven K Anderson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1265587497 PECOS PAC ID: 1850482472 Enrollment ID: I20070810000132 |
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