Organization · Type 2 NPI
Edison Lakes Oral Surgery, P.c.
Oral and Maxillofacial Surgery Clinic/Center · South Bend, IN
NPI number
1881887065
Active
Practice location
3367 Douglas Rd
South Bend, IN 46635-1779
Fax (574) 277-1837
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | None listed |
| Oral and Maxillofacial Surgery Clinic/Center Primary | 261QS0112X | 12010802A (IN) |
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.
3 other providers at this address
- Edward Charles Collins Iii, DDSOral and Maxillofacial Surgery (Dentist) South Bend, IN NPI 1235454950
- Lane Tremelling Haws, DMD, MDOral and Maxillofacial Surgery (Dentist) South Bend, IN NPI 1316409147
- William Lawrence Hull Iii, DMDOral and Maxillofacial Surgery (Dentist) South Bend, IN NPI 1639483647
About NPI 1881887065
Edison Lakes Oral Surgery, P.c.'s National Provider Identifier is 1881887065, issued on Aug 22, 2007. The primary taxonomy on file is Oral and Maxillofacial Surgery Clinic/Center (261QS0112X), and the practice location is in South Bend, IN. The record was last updated on May 6, 2024.