Oral And Maxillofacial Surgery, P.c. | |
1612 N Baldwin Ave Marion IN 46952-1872 | |
(765) 662-2068 | |
(765) 662-3210 |
Full Name | Oral And Maxillofacial Surgery, P.c. |
---|---|
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1612 N Baldwin Ave, Marion, Indiana |
Authorized Official Name and Position | Lynn E Johnson (OFFICE MANAGER) |
Authorized Official Contact | 7656622068 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Oral And Maxillofacial Surgery, P.c. 1612 N Baldwin Ave Marion IN 46952-1872 Ph: (765) 662-2068 | Oral And Maxillofacial Surgery, P.c. 1612 N Baldwin Ave Marion IN 46952-1872 Ph: (765) 662-2068 |
NPI Number | 1235248329 |
---|---|
Provider Enumeration Date | 08/30/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235248329 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 1223S0112X (Indiana) | Primary |
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