Midwest Oral And Maxillofacial Surgery P C in Fort Wayne - Oral And Maxillofacial Surgery
Midwest Oral And Maxillofacial Surgery P C - NPI 1558416883
Midwest Oral And Maxillofacial Surgery P C is a Oral And Maxillofacial Surgery in Fort Wayne, Indiana. Midwest Oral And Maxillofacial Surgery P C practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Midwest Oral And Maxillofacial Surgery P C is 1558416883. The last update date is 2009-03-26.
Midwest Oral And Maxillofacial Surgery P C's current location address is 3303 Trier Rd, Fort Wayne, Indiana. You can contact this provider via phone number 2604849990 and fax number 2604846573. The mailing address for Midwest Oral And Maxillofacial Surgery P C is 3303 Trier Rd, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Midwest Oral And Maxillofacial Surgery P C |
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Address | 3303 Trier Rd, Fort Wayne, Indiana |
Phone Number | 2604849990 |
Fax Number | 2604846573 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | PRESIDENT |
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Authorized Official Name | Iczkovitz L Michael |
Credentials | DDS |
Telephone Number | 2604849990 |
NPI Number Detail
NPI Number | 1558416883 |
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Provider Enumeration Date | 2007-01-25 |
Last Updated Date | 2009-03-26 |
Provider Mailing Address Detail
Address | 3303 Trier Rd |
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City | Fort Wayne |
State | Indiana (IN) |
Post Code | 468154768 |
Phone Number | 2604849990 |
Fax Number | 2604846573 |
Provider's Primary Taxonomy Detail
Speciality | Oral And Maxillofacial Surgery |
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Taxonomy | 1223S0112X |
Licence No | 54000677 |
Definition: 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. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
200147450 | IN | -- |
Post Comment/ Review Below
What is the Midwest Oral And Maxillofacial Surgery P C's 1558416883?
The Midwest Oral And Maxillofacial Surgery P C's NPI (National Provider Identifier) Number is 1558416883. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Midwest Oral And Maxillofacial Surgery P C?
The Midwest Oral And Maxillofacial Surgery P C is situated at 3303 Trier Rd, in the city of Fort Wayne, state of IN, with the zip code 468154768.
What is Midwest Oral And Maxillofacial Surgery P C's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Midwest Oral And Maxillofacial Surgery P C is Oral And Maxillofacial Surgery, and the taxonomy classification code that categorizes this area of expertise is 1223S0112X.
When did Midwest Oral And Maxillofacial Surgery P C receive its 1558416883 assignment?
The Midwest Oral And Maxillofacial Surgery P C was assigned its 1558416883 on 2007-01-25, which is the date when this unique identifier was issued to the organization.
As of what date was the information pertaining to Midwest Oral And Maxillofacial Surgery P C, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Midwest Oral And Maxillofacial Surgery P C, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2009-03-26.
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