OPTIMUM ORAL SURGERY GROUP LLC; NPI #1003264326

Contact Information

OPTIMUM ORAL SURGERY GROUP LLC

2301 E EVESHAM RD
SUITE 211
VOORHEES TOWNSHIP, NJ 08043-4501

Phone: 856-772-1500
Fax: 856-772-0711
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for OPTIMUM ORAL SURGERY GROUP LLC

NPI Number 1003264326

LBN Legal business name OPTIMUM ORAL SURGERY GROUP LLC

Authorized official DONALD REBHUN - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/26/2016

Last updated 08/27/2019 - About 7 years ago

Identifiers

License #

12708

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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