Individual ProviderSteven R SewallDentistDental ProvidersPractice Address840 N 87th St, Oral And Maxillofacial Surgery, Milwaukee, WI 53226-3586(414) 805-5781PECOS EnrollmentBased on the most recent information from CMS, provider Steven R Sewall does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1821042706Provider TypeIndividualFull NameSewall, Steven RTitleMs.CredentialDDSGenderMaleSole ProprietorNoEnumeration Date5/22/2006Last Updated9/25/2014Contact InformationPractice LocationPractice Address840 N 87th St, Oral And Maxillofacial Surgery, Milwaukee, WI 53226-3586Phone(414) 805-5781Fax(414) 259-9115Mailing LocationMailing Address840 N 87th St, Oral And Maxillofacial Surgery, Milwaukee, WI 53226-3586Phone(414) 805-5781Fax(414) 259-9115Provider TaxonomiesCodeDescriptionLicenseCode1223S0112XPrimaryDescriptionDentistDental ProvidersLicense5002150WisconsinProvider IdentifiersIDDescriptionIssuerID1821042706DescriptionMedicaidIssuerUnlistedWisconsinID002000135HDescriptionOtherIssuerHUMANA