Organization · Type 2 NPI

College Park Oral & Maxillofacial Surgery

Oral and Maxillofacial Surgery (Dentist) · Indianapolis, IN

NPI number 1043309719 Active

Practice location

3677 W 86th Street
Indianapolis, IN 46268-1902

Fax (317) 872-3174

Mailing address

3677 W 86th Street
Indianapolis, IN 56268-1902

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112XNone listed

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1043309719

College Park Oral & Maxillofacial Surgery's National Provider Identifier is 1043309719, issued on Oct 12, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Indianapolis, IN. The record was last updated on Aug 22, 2020.