Organization · Type 2 NPI
Lakeside Oral & Implant Surgery Institute, PC
Oral and Maxillofacial Surgery Clinic/Center · Chicago, IL
Practice location
5758 S Maryland Ave # 4H
Chicago, IL 60637-1426
Fax (773) 834-3888
Mailing address
5841 S Maryland Ave # MC9020
Chicago, IL 60637-1443
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery Clinic/Center Primary | 261QS0112X | 021002718 (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.
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About NPI 1679070189
Lakeside Oral & Implant Surgery Institute, PC's National Provider Identifier is 1679070189, issued on Apr 11, 2018. The primary taxonomy on file is Oral and Maxillofacial Surgery Clinic/Center (261QS0112X), and the practice location is in Chicago, IL. The record was last updated on Apr 11, 2018.