Organization · Type 2 NPI

Kankakee Valley Oral Maxillofacial Surgery PC

Oral and Maxillofacial Surgery (Dentist) · Bourbonnais, IL

NPI number 1245822162 Active

Practice location

31 Briarcliff Professional Ctr.
Bourbonnais, IL 60914

Fax (815) 933-0990

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 1245822162

Kankakee Valley Oral Maxillofacial Surgery PC's National Provider Identifier is 1245822162, issued on Feb 11, 2021. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Bourbonnais, IL. The record was last updated on Feb 11, 2021.