Grand Traverse Oral Surgery, P.C. in Traverse City - Oral And Maxillofacial Surgery
Grand Traverse Oral Surgery, P.C. - NPI 1003095605
Grand Traverse Oral Surgery, P.C. is a Oral And Maxillofacial Surgery in Traverse City, Michigan. Grand Traverse Oral Surgery, P.C. practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Grand Traverse Oral Surgery, P.C. is 1003095605. The last update date is 2008-03-19.
Grand Traverse Oral Surgery, P.C.'s current location address is 12776 S West Bay Shore Dr, Traverse City, Michigan. You can contact this provider via phone number 2319463512 and fax number 2319461908. The mailing address for Grand Traverse Oral Surgery, P.C. is 12776 S West Bay Shore Dr, Traverse City, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grand Traverse Oral Surgery, P.C. |
|---|---|
| Address | 12776 S West Bay Shore Dr, Traverse City, Michigan |
| Phone Number | 2319463512 |
| Fax Number | 2319461908 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OFFICE MAN |
|---|---|
| Authorized Official Name | Schlueter J. Susan |
| Telephone Number | 2319463512 |
NPI Number Detail
| NPI Number | 1003095605 |
|---|---|
| Provider Enumeration Date | 2007-10-31 |
| Last Updated Date | 2008-03-19 |
Provider Mailing Address Detail
| Address | 12776 S West Bay Shore Dr |
|---|---|
| City | Traverse City |
| State | Michigan (MI) |
| Post Code | 496845451 |
| Phone Number | 2319463512 |
| Fax Number | 2319461908 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
|
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 |
|---|---|---|---|
| 0P21110 | MI | MEDICARE GROUP # |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Grand Traverse Oral Surgery, P.C. by the Centers for Medicare & Medicaid Services?
The Grand Traverse Oral Surgery, P.C. has been assigned the NPI (National Provider Identifier) 1003095605 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Grand Traverse Oral Surgery, P.C. located?
The Grand Traverse Oral Surgery, P.C. is located at 12776 S West Bay Shore Dr, Traverse City, MI 496845451.
What is Grand Traverse Oral Surgery, P.C.'s primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Grand Traverse Oral Surgery, P.C. is Oral And Maxillofacial Surgery, and the corresponding taxonomy classification code for this specialized field is 1223S0112X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1003095605 to Grand Traverse Oral Surgery, P.C.?
The Centers for Medicare & Medicaid Services originally issued the 1003095605 to Grand Traverse Oral Surgery, P.C. on 2007-10-31.
When was the Grand Traverse Oral Surgery, P.C.'s information last updated?
The Grand Traverse Oral Surgery, P.C.'s information was last updated on 2008-03-19.
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