National Provider Identifier Database

GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY 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

GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC
100 BRYANT ST
DUBUQUE, IA52003-7405
Phone: 563-557-1440
Fax: 563-557-7001
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC

NPI Number 1992799811
Legal business name
LBN
GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC
Authorized official THOMAS WILLIAMS - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 09/07/2005
Last updated 08/22/2020 - About 6 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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