Organization · Type 2 NPI
Facial Cosmetic & Reconstructive Surgery, SC
Oral and Maxillofacial Surgery Clinic/Center · Dunlap, IL
NPI number
1417123076
Active
Practice location
11825 N Knoxville Ave
Dunlap, IL 61525-8842
Fax (309) 243-8983
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery Clinic/Center Primary | 261QS0112X | 019025195 (IL) |
Oral and Maxillofacial Surgery Clinic/Center: 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.
2 other providers at this address
About NPI 1417123076
Facial Cosmetic & Reconstructive Surgery, SC's National Provider Identifier is 1417123076, issued on May 5, 2008. The primary taxonomy on file is Oral and Maxillofacial Surgery Clinic/Center (261QS0112X), and the practice location is in Dunlap, IL. The record was last updated on May 5, 2008.