MEDICARE: ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA

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	:	1780765495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA

Provider Business Mailing Address
First Line	:	20 LONG CREEK DR
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-2425
Country	:	US
Telephone Number	:	207-772-4063
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 LONG CREEK DR
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-2425
Country	:	US
Telephone Number	:	207-772-4063
Fax Number	:

Authorized Official
Title or Position	:	PARTNER/PRACTICE OWNER
Name	:	DR. MARK D ZAJKOWSKI
Credential	:	DDS, MD MBA, FACS
Telephone Number	:	207-772-4063

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	11/01/2023

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Directions to “ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA ” Practice Location

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