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NPI Profile for ST CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC in RICHMOND, MI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery | |
Oral and Maxillofacial Surgery |
261QS0112X |
| NPI # | 1710879697 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/16/2025 | |
| Last updated | 07/16/2025 - About 11 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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ST. CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC