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Mgm19 Inc
Oral and Maxillofacial Surgery (Dentist) in Saint Charles, Illinois
NPI 1215579008

Mgm19 Inc is a Oral and Maxillofacial Surgery (Dentist) based in Saint Charles, IL and is specialized in Oral and Maxillofacial Surgery. Mgm19 Inc practices in Saint Charles, IL. The NPI Number for Mgm19 Inc is 1215579008 and holds a License No. (Illinois).

The current practice location address for Mgm19 Inc is 605 Courtyard Dr, Saint Charles, IL and can be reached out via phone at 630-377-7077.

Location: 605 Courtyard Dr, Saint Charles, IL, 60174-1463
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215579008
Provider Name
Mgm19 Inc
Credential
Provider Entity Type
Organization
Address
605 Courtyard Dr, Saint Charles, IL, 60174-1463
Phone Number
630-377-7077
Fax Number
Provider Enumeration Date
10/13/2019
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
021.002827 01 IL SPECIALIST LICENSE DENTISTRY
036.144437 01 IL MEDICAL LICENSE
1518250125 01 IL NPI
019.029613 01 IL DENTAL LICENSE
institution
Provider Business Practice Location Address Details
Address
605 Courtyard Dr
City
Saint Charles
State
Illinois
Zip
60174-1463
Phone Number
630-377-7077
Fax Number
person
Provider Business Mailing Address Details
Address
605 Courtyard Dr
City
Saint Charles
State
Illinois
Zip
60174-1463
Phone Number
630-377-7077
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
()
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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