Renaissance Oral Surgery Pc in Roseville - Plastic Surgery Within The Head And Neck
Renaissance Oral Surgery Pc - NPI 1235325499
Renaissance Oral Surgery Pc is a Plastic Surgery Within The Head And Neck in Roseville, Michigan. Renaissance Oral Surgery Pc practices all healthcare services and medical treatments related to Plastic Surgery Within The Head And Neck. The NPI Number for Renaissance Oral Surgery Pc is 1235325499. The last update date is 2013-10-01.
Renaissance Oral Surgery Pc's current location address is 20805 E 12 Mile Rd, Roseville, Michigan. You can contact this provider via phone number 5867782100 and fax number 5867782422. The mailing address for Renaissance Oral Surgery Pc is 20805 E 12 Mile Rd, Roseville, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Renaissance Oral Surgery Pc |
|---|---|
| Address | 20805 E 12 Mile Rd, Roseville, Michigan |
| Phone Number | 5867782100 |
| Fax Number | 5867782422 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Bryan Henry |
| Credentials | DDS |
| Telephone Number | 5867782100 |
NPI Number Detail
| NPI Number | 1235325499 |
|---|---|
| Provider Enumeration Date | 2007-09-21 |
| Last Updated Date | 2013-10-01 |
Provider Mailing Address Detail
| Address | 20805 E 12 Mile Rd |
|---|---|
| City | Roseville |
| State | Michigan (MI) |
| Post Code | 48066 |
| Phone Number | 5867782100 |
| Fax Number | 5867782422 |
Provider's Primary Taxonomy Detail
| Speciality | Plastic Surgery Within The Head And Neck |
|---|---|
| Taxonomy | 2082S0099X |
|
Definition: A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 975506164 | MI | BC/BS MEDICARE ADVANTAGE | |
| U33701 | MI | HAP | |
| 2856 | MI | GOLDEN DENTAL | |
| 128744 | MI | CARE CHOICES | |
| 975506164 | MI | BC/BS OF MI | |
| P00230001 | MI | MEDICARE PROVIDER |
Post Comment/ Review Below
What is the Renaissance Oral Surgery Pc's unique identification number?
The Renaissance Oral Surgery Pc has been assigned the NPI (National Provider Identifier) Number 1235325499 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Renaissance Oral Surgery Pc?
The Renaissance Oral Surgery Pc is situated at 20805 E 12 Mile Rd, in the city of Roseville, state of MI, with the zip code 48066.
What is Renaissance Oral Surgery Pc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Renaissance Oral Surgery Pc is Plastic Surgery Within The Head And Neck, and the taxonomy code that classifies this field of practice is 2082S0099X.
On what date did Renaissance Oral Surgery Pc receive its 1235325499 assignment from the Centers for Medicare & Medicaid Services?
The Renaissance Oral Surgery Pc was assigned its 1235325499 on 2007-09-21, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Renaissance Oral Surgery Pc most recently updated or revised?
The information pertaining to Renaissance Oral Surgery Pc, including its address, specialty, and other relevant details, was last updated or revised on 2013-10-01.