Midwest Oral And Maxillofacial Surgery P C in Fort Wayne - Oral And Maxillofacial Surgery
Midwest Oral And Maxillofacial Surgery P C - NPI 1598781106
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 1598781106. The last update date is 2010-10-12.
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 |
|---|---|
| Address | 3303 Trier Rd, Fort Wayne, Indiana |
| Phone Number | 2604849990 |
| Fax Number | 2604846573 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Iczkovitz L. Michael |
| Credentials | D.D.S. |
| Telephone Number | 2604849990 |
NPI Number Detail
| NPI Number | 1598781106 |
|---|---|
| Provider Enumeration Date | 2006-07-15 |
| Last Updated Date | 2010-10-12 |
Provider Mailing Address Detail
| Address | 3303 Trier Rd |
|---|---|
| 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 |
|---|---|
| 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. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200147450 | IN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Midwest Oral And Maxillofacial Surgery P C by the Centers for Medicare & Medicaid Services (CMS)?
The Midwest Oral And Maxillofacial Surgery P C has been assigned the NPI (National Provider Identifier) 1598781106. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Midwest Oral And Maxillofacial Surgery P C's physical address?
The Midwest Oral And Maxillofacial Surgery P C is physically located at 3303 Trier Rd, in the city of Fort Wayne, IN, with the postal code 468154768.
What is Midwest Oral And Maxillofacial Surgery P C's area of expertise and its corresponding taxonomy classification?
The Midwest Oral And Maxillofacial Surgery P C's field of specialization is Oral And Maxillofacial Surgery, and it falls under the taxonomy code 1223S0112X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1598781106 to Midwest Oral And Maxillofacial Surgery P C?
The Centers for Medicare & Medicaid Services originally issued the 1598781106 to Midwest Oral And Maxillofacial Surgery P C on 2006-07-15.
When was the information regarding Midwest Oral And Maxillofacial Surgery P C most recently updated?
The details pertaining to the Midwest Oral And Maxillofacial Surgery P C, including its address, specialty, and other relevant information, were last refreshed on 2010-10-12.