Maxillofacial Surgery Innovative Services

LBN: Maxillofacial Surgery Innovative Services
Maxillofacial Surgery Innovative Services is an health care organization with primary practice located at 1284 Som Center Rd Ste 219 , Mayfield Heights OH 44124-2048. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Maxillofacial Surgery Innovative Services can be contacted via phone (888) 774-7773, or through Hancock, Michelle Ann via phone (515) 321-6451.

Contact Information

Primary practice address
1284 Som Center Rd Ste 219 Mayfield Heights OH 44124-2048
Phone: (888) 774-7773
Fax: (888) 774-7970
Website:
Map and Directions
Authorized official contact:
Name: Hancock, Michelle Ann MS/P, MBA/HCM
Phone: (515) 321-6451

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1962929240
LBN Legal business name Maxillofacial Surgery Innovative Services
DBA Doing business as
Authorized official Hancock, Michelle Ann MS/P, MBA/HCM
Entity Organization
Organization subpart 1 No
Enumeration date Aug 28th, 2017
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962929240 NPPES
Ohio MEDICAID 2855503

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