Midwest Oral And Maxillofacial Surgery P C

LBN: Midwest Oral And Maxillofacial Surgery P C
Midwest Oral And Maxillofacial Surgery P C is an health care organization with primary practice located at 3303 Trier Rd , Fort Wayne IN 46815-4768. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Midwest Oral And Maxillofacial Surgery P C can be contacted via phone (260) 484-9990, or through Iczkovitz, Michael L. via phone (260) 484-9990.

Contact Information

Primary practice address
3303 Trier Rd Fort Wayne IN 46815-4768
Phone: (260) 484-9990
Fax: (260) 484-6573
Website:
Map and Directions
Authorized official contact:
Name: Iczkovitz, Michael L. Doctor of Dental Surgery (DDS)
Phone: (260) 484-9990

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 54000677 Indiana

Profile Details

NPI number 1598781106
LBN Legal business name Midwest Oral And Maxillofacial Surgery P C
DBA Doing business as
Authorized official Iczkovitz, Michael L. Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 15th, 2006
Last updated Oct 12th, 2010 - about 14 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 1598781106 NPPES
Indiana MEDICAID 200147450

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