MEDICARE: ORAL SURGERY ASSOCIATES OF MILWAUKEE SC

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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number	:	1780850263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORAL SURGERY ASSOCIATES OF MILWAUKEE SC

Provider Business Mailing Address
First Line	:	7801 S HOWELL AVE
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-2134
Country	:	US
Telephone Number	:	414-764-2880
Fax Number	:	414-764-2882

Provider Business Practice Location Address
First Line	:	7801 S HOWELL AVE
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-2134
Country	:	US
Telephone Number	:	414-764-2880
Fax Number	:	414-764-2882

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALAN A KIMMEL
Credential	:
Telephone Number	:	262-241-0900

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	07/30/2025

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