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Contact Information

PROVIDENCE ORAL SURGERY AND DENTAL IMPLANT CENTER
102 WAXHAW PROFESSIONAL PARK DR STE G
WAXHAW, NC28173-5024
 Phone: 732-547-9101
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

NPI Profile & details for PROVIDENCE ORAL SURGERY AND DENTAL IMPLANT CENTER

NPI Number 1912468463
LBN Legal business name PROVIDENCE ORAL SURGERY AND DENTAL IMPLANT CENTER
Authorized official JAMES PARELLI - (ORAL SURGEON/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/27/2019
Last updated 10/26/2021 - About 5 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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