Organization · Type 2 NPI

Lake Michigan Oral & Maxillofacial Surgery PLLC

Oral and Maxillofacial Surgery (Dentist) · St. Joseph, MI

NPI number 1245544824 Active

Practice location

3950 Hollywood Rd, 290
St. Joseph, MI 49085-9151

Call (405) 848-7974 Map

Fax (405) 848-0033

Mailing address

3000 United Founders Blvd, 237
Oklahoma City, OK 73112-3958

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X2901018748 (MI)

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.

55 other providers at this address

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About NPI 1245544824

Lake Michigan Oral & Maxillofacial Surgery PLLC's National Provider Identifier is 1245544824, issued on Aug 5, 2010. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in St. Joseph, MI. The record was last updated on Aug 5, 2010.