Great Lakes Oral & Maxillofacial Surgery, P.A.
NPI 1205136074 · Oral and Maxillofacial Surgery (Dentist) · New Richmond, WI
Great Lakes Oral & Maxillofacial Surgery, P.A. is a Oral and Maxillofacial Surgery (Dentist) organization in New Richmond, WI (NPI 1205136074).
Provider details
- NPI number
- 1205136074
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Connie Miller, Practice Manager(651) 351-1010
- License
- 4482 (WI)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-10-27
- Last updated
- 2010-10-27
Frequently asked questions
- What is Great Lakes Oral & Maxillofacial Surgery, P.A.'s NPI number?
- Great Lakes Oral & Maxillofacial Surgery, P.A.'s National Provider Identifier (NPI) is 1205136074, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Lakes Oral & Maxillofacial Surgery, P.A.?
- Great Lakes Oral & Maxillofacial Surgery, P.A. is classified in the NPPES registry as Oral and Maxillofacial Surgery (Dentist) (Dental Providers).
- Where is Great Lakes Oral & Maxillofacial Surgery, P.A. located?
- Great Lakes Oral & Maxillofacial Surgery, P.A.'s practice location on file with NPPES is 227 Meridian Dr # 6, New Richmond, WI 54017-2565.
- What is Great Lakes Oral & Maxillofacial Surgery, P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Great Lakes Oral & Maxillofacial Surgery, P.A. is (715) 246-5150.
- Who is the authorized official for Great Lakes Oral & Maxillofacial Surgery, P.A.?
- The authorized official listed on Great Lakes Oral & Maxillofacial Surgery, P.A.'s NPPES record is Connie Miller, Practice Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Lakes Oral & Maxillofacial Surgery, P.A.'s NPI active?
- Yes — Great Lakes Oral & Maxillofacial Surgery, P.A.'s NPI (1205136074) is active in the NPPES registry as of the last update on 2010-10-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.