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General NPI Number Information
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NPI Number | 1578613873
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Entity Type | Organization
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Legal Business Name | LOUIS G. CHMURA DDS, MS, PC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 214 WINSTON DR
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City | MARSHALL
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State | MI
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Zip | 49068-8526
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Country | US
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Telephone | 269-781-4000
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Fax | 269-781-2850
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Provider Business Mailing Address
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Address Line | 214 WINSTON DR
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City | MARSHALL
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State | MI
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Zip | 49068-8526
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Country | US
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Telephone | 269-781-4000
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Fax | 269-781-2850
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOUIS G. CHMURA
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Credential | DDS, MS
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Telephone | 269-781-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2901014061
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License Number State | MI
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