National Provider Identifier Database

ST CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC
Oral & Maxillofacial Surgery


Contact Information

ST. CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC
36610 HERITAGE DR
RICHMOND, MI48062-1937
Phone: 586-727-6880
Fax: 586-727-6880
Website:
Specialty Taxonomy Code
* Oral & Maxillofacial Surgery 204E00000X
Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for ST. CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC

NPI Number 1710879697
Legal business name
LBN
ST. CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC
Authorized official NICHOLAS BOURNIAS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/16/2025
Last updated 07/16/2025 - About 11 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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