ORAL SURGERY CENTER OF KOKOMO LLC; NPI #1992124879

Contact Information

ORAL SURGERY CENTER OF KOKOMO LLC

3415 S LAFOUNTAIN ST
SUITE H
KOKOMO, IN 46902-3802

Phone: 765-453-7710
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Oral and Maxillofacial Surgery	1223S0112X	19	Oral Surgery (Dentist only)
Oral and Maxillofacial Pathology	1223P0106X
Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for ORAL SURGERY CENTER OF KOKOMO LLC

NPI Number 1992124879

LBN Legal business name ORAL SURGERY CENTER OF KOKOMO LLC

Authorized official JOHN LADD - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/08/2014

Last updated 04/08/2014 - About 12 years ago

Identifiers

License #

12012039A

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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