National Provider Identifier Database

SOUTH SHORE OMS PC
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

SOUTH SHORE OMS PC
19249 ALLEN RD
BROWNSTOWN TOWNSHIP, MI48183-1189
Phone: 734-479-2990
Fax: 734-479-2991
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for SOUTH SHORE OMS PC

NPI Number 1861122871
Legal business name
LBN
SOUTH SHORE OMS PC
Authorized official KELLY DOHERTY - (ADMINISTRATIVE)
Entity Organization
Organization subpart No
Enumeration date 06/13/2022
Last updated 06/13/2022 - About 4 years 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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