Oral & Maxillofacial Surgery Associates Of Western Michigan Plc
LBN: Oral & Maxillofacial Surgery Associates Of Western Michigan Plc
Oral & Maxillofacial Surgery Associates Of Western Michigan Plc is an health care organization with primary practice located at 2140 Lake Michigan Dr Nw , Grand Rapids MI 49504-4785. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as the primary health care specialty.
Oral & Maxillofacial Surgery Associates Of Western Michigan Plc can be contacted via phone (616) 791-9600, or through Domin, J Mark via phone (616) 791-9600.
Contact Information
Primary practice address
2140 Lake Michigan Dr Nw
Grand Rapids MI 49504-4785
Phone: (616) 791-9600
Fax: (616) 791-9603
Website:
Authorized official contact:
Name: Domin, J Mark Doctor of Dental Surgery (DDS)
Phone: (616) 791-9600
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X |
Profile Details
| NPI number | 1598772626 |
|---|---|
| LBN Legal business name | Oral & Maxillofacial Surgery Associates Of Western Michigan Plc |
| DBA Doing business as | |
| Authorized official | Domin, J Mark Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | Apr 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598772626 | NPPES |
| Other | 970D111530 | BCBSM BCN/CHOICE | |
| Other | CC0861 | BCBSM BCN/CHOICE | |
| Other | 0N13750 | BCBSM BCN/CHOICE |
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