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NPI Profile for ORAL SURGERY CENTER OF KOKOMO LLC in KOKOMO, IN.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) | |
Oral and Maxillofacial Pathology |
1223P0106X | |||
Oral and Maxillofacial Surgery |
261QS0112X |
| NPI Number | 1992124879 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/08/2014 | |
| Last updated | 04/08/2014 - About 12 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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ORAL SURGERY CENTER OF KOKOMO LLC
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ORAL SURGERY CENTER OF KOKOMO LLC