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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 Specialty Code Provider Type

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

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

NPI Number 1992799811
LBN Legal business name GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC
Authorized official THOMAS WILLIAMS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/07/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers n/a
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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