Oral And Maxillofacial Surgery Asso Of Eau Claire Sc - Medicare Dental Clinic in Altoona, WI

Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is a medicare enrolled dental clinic (Oral & Maxillofacial Surgery) in Altoona, Wisconsin. The current practice location for Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is 788 Oakleaf Way, Altoona, Wisconsin. For appointments, you can reach them via phone at (715) 834-8414. The mailing address for Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is 1120 Oak Ridge Drive, Eau Claire, Wisconsin and phone number is (715) 834-8414.

Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is licensed to practice in Wisconsin (license number 4495-015). The clinic also participates in the medicare program and its NPI number is 1316954928. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (715) 834-8414.

Contact Information

Oral And Maxillofacial Surgery Asso Of Eau Claire Sc
788 Oakleaf Way
Altoona
WI 54720
(715) 834-8414
(715) 834-3557

Dental Care Clinic Profile

Full NameOral And Maxillofacial Surgery Asso Of Eau Claire Sc
SpecialityOral & Maxillofacial Surgery
Location788 Oakleaf Way, Altoona, Wisconsin
Authorized Official Name and PositionGina K Thor (TRANSCRIPTION AND CREDENTIALING)
Authorized Official Contact7158348414
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Oral And Maxillofacial Surgery Asso Of Eau Claire Sc
1120 Oak Ridge Drive
Eau Claire
WI 54701

Ph: (715) 834-8414
Oral And Maxillofacial Surgery Asso Of Eau Claire Sc
788 Oakleaf Way
Altoona
WI 54720

Ph: (715) 834-8414

NPI Details:

NPI Number1316954928
Provider Enumeration Date08/03/2006
Last Update Date07/26/2018

Medicare PECOS Information:

Medicare PECOS PAC ID1456355643
Medicare Enrollment IDO20060830000344

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Medical Identifiers

Medical identifiers for Oral And Maxillofacial Surgery Asso Of Eau Claire Sc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316954928NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223E0200XDentist - Endodontics (* (Not Available))Secondary
1223E0200XDentist - Endodontics 6222-15 (Wisconsin)Secondary
1223E0200XDentist - Endodontics 4412-015 (Wisconsin)Secondary
1223S0112XDentist - Oral And Maxillofacial Surgery (* (Not Available))Secondary
204E00000XOral & Maxillofacial Surgery 4495-015 (Wisconsin)Primary
204E00000XOral & Maxillofacial Surgery 4680-015 (Wisconsin)Secondary
204E00000XOral & Maxillofacial Surgery 5112-015 (Wisconsin)Secondary
204E00000XOral & Maxillofacial Surgery 5563-015 (Wisconsin)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Oral And Maxillofacial Surgery Asso Of Eau Claire Sc acts as a billing entity for following providers:
Provider NameIan Dozier
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1023027786
PECOS PAC ID: 9032116132
Enrollment ID: I20061102000539

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Provider NameSlavko Ivankovic
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1639241342
PECOS PAC ID: 1658555388
Enrollment ID: I20110405000244

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Provider NameMark D Millington
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1205908936
PECOS PAC ID: 2264609759
Enrollment ID: I20120124000949

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› Verified 3 days ago

Provider NameJeffrey S Goetz
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1447322219
PECOS PAC ID: 5496916165
Enrollment ID: I20120406000013

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› Verified 3 days ago

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› Verified 3 days ago


Dental Clinics in Altoona, WI


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