MEDICARE: ORAL & MAXILLOFACIAL SURGERY CENTERS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487826046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORAL & MAXILLOFACIAL SURGERY CENTERS INC

Provider Business Mailing Address
First Line	:	24561 STATE ROUTE 23 SOUTH
Second Line	:
City	:	CIRCLEVILLE
State	:	OH
Zip	:	43113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3824 HOOVER RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2454
Country	:	US
Telephone Number	:	740-477-8544
Fax Number	:

Authorized Official
Title or Position	:	ACCOUNTS RECEIVABLE COORDINATOR
Name	:	MRS. TAMI DOYLE
Credential	:
Telephone Number	:	740-477-8544

Provider Enumeration Date	:	03/24/2008
Last Update Date	:	03/24/2008

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