Healthcare Provider Details

I. General information

NPI: 1497927081
Provider Name (Legal Business Name): ORAL & MAXILLOFACIAL SURGERY CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1456 MARION WALDO RD
MARION OH
43302-7422
US

IV. Provider business mailing address

24561 STATE ROUTE 23 SOUTH
CIRCLEVILLE OH
43113
US

V. Phone/Fax

Practice location:
  • Phone: 740-477-8544
  • Fax:
Mailing address:
  • Phone: 740-477-8544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMI DOYLE
Title or Position: ACCOUNTS RECEIVABLE COORDINATOR
Credential:
Phone: 740-477-8544