Organization · Type 2 NPI

Central Illinois Oral and Maxillofacial Surgery, PC

Oral and Maxillofacial Surgery (Dentist) · Champaign, IL

NPI number 1669540399 Active

Practice location

14 E Anthony Dr, Suite C
Champaign, IL 61820-2748

Fax (217) 355-5921

Specialties and licenses

Taxonomy	Code	License
Oral and Maxillofacial Surgery (Dentist) Primary	1223S0112X	None 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.

3 other providers at this address

Other oral and maxillofacial surgery (dentist) providers in Champaign

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NPI record

NPI: 1669540399
Entity type: Organization (Type 2)
Issued: Dec 1, 2006
Last updated: Aug 23, 2023
Status: Active
Subpart: Yes of Central Illinois Oral and Maxillofacial Surgery, PC

Other names

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Champaign Oral Surgery Center · doing business as
Champaign Oral Surgery Center · doing business as

Authorized official

Amy M Kroeger
Insurance Coordinator
(217) 540-5100

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About NPI 1669540399

Central Illinois Oral and Maxillofacial Surgery, PC's National Provider Identifier is 1669540399, issued on Dec 1, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Champaign, IL. The record was last updated on Aug 23, 2023.