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NPI Code Detail

MEDICARE: DONALD E. ROMSA, D.D.S., S.C.

MEDICARE: DONALD E. ROMSA, D.D.S., S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)0002539WI

General Provider Information

NPI Number : 1427446913
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONALD E. ROMSA, D.D.S., S.C.
Provider Business Mailing Address
First Line : 5801 WASHINGTON AVE
Second Line : 102
City : MOUNT PLEASANT
State : WI
Zip : 53406-4057
Country : US
Telephone Number : 262-886-0147
Fax Number : 262-886-0570
Provider Business Practice Location Address
First Line : 5801 WASHINGTON AVE
Second Line : 102
City : MOUNT PLEASANT
State : WI
Zip : 53406-4057
Country : US
Telephone Number : 262-886-0147
Fax Number : 262-886-0570
Authorized Official
Title or Position : ORAL SURGEON
Name : DR. DONALD EDWARD ROMSA
Credential : D.D.S.
Telephone Number : 262-886-0147
Provider Enumeration Date : 01/06/2015
Last Update Date : 01/06/2015

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