institution
Michiana Oral &maxillofacial Surgery Llc
Oral and Maxillofacial Surgery (Dentist) in South Bend, Indiana
NPI 1093775272

Michiana Oral &maxillofacial Surgery Llc is a Oral and Maxillofacial Surgery (Dentist) based in South Bend, IN and is specialized in Oral and Maxillofacial Surgery. Michiana Oral &maxillofacial Surgery Llc practices in South Bend, IN. The NPI Number for Michiana Oral &maxillofacial Surgery Llc is 1093775272 and holds a License No. 12008287 (Indiana).

The current practice location address for Michiana Oral &maxillofacial Surgery Llc is 707 N Michigan St, South Bend, IN and can be reached out via phone at 574-289-0080 and via fax at 574-287-6320.

Location: 707 N Michigan St, South Bend, IN, 46601-1070
institution
Provider Profile Details
NPI Number
1093775272
Provider Name
Michiana Oral &maxillofacial Surgery Llc
Credential
Provider Entity Type
Organization
Address
707 N Michigan St, South Bend, IN, 46601-1070
Phone Number
574-289-0080
Fax Number
574-287-6320
Provider Enumeration Date
03/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100409820A 05 IN
institution
Provider Business Practice Location Address Details
Address
707 N Michigan St
City
State
Zip
46601-1070
Phone Number
574-289-0080
Fax Number
574-287-6320
person
Provider Business Mailing Address Details
Address
707 N Michigan St
City
State
Zip
46601-1070
Phone Number
574-289-0080
Fax Number
574-287-6320
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
12008287 (Indiana)
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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