National Provider Identifier Database

BUCKEYE ORAL MAXILLOFACIAL SURGEY
Oral and Maxillofacial Surgery

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.


Contact Information

BUCKEYE ORAL & MAXILLOFACIAL SURGEY
110 POLARIS PARKWAY
SUITE 110
WESTERVILLE, OH43082-0000
Phone: 614-794-9700
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for BUCKEYE ORAL & MAXILLOFACIAL SURGEY

NPI Number 1073855193
Legal business name
LBN
BUCKEYE ORAL & MAXILLOFACIAL SURGEY
Authorized official JACK MCEWAN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/27/2013
Last updated 03/27/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • OH License #: 30022456
  • OH Medicaid: 2711882

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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