WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC; NPI #1619026564

Contact Information

WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC

1635 S PLAZA WAY
FLAGSTAFF, AZ 86001-7102

Phone: 928-214-7052
Fax: 928-214-7059
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral & Maxillofacial Surgery	204E00000X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC

NPI # 1619026564

LBN Legal business name WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC

Authorized official MARK CRANE - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/09/2007

Last updated 08/22/2020 - About 6 years ago

Identifiers

AZ	License #	26402
AZ	Medicaid	545345

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC

Contact Information

Specialty

Oral & Maxillofacial Surgery

NPI Profile & details for WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC

Reviews for WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC