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 7230 Engle Rd Suite 301, Fort Wayne IN 46804-2209. 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) 432-5566, or through Iczkovitz, Michael L via phone (260) 484-9990.
Contact Information
Primary practice address
7230 Engle Rd Suite 301
Fort Wayne IN 46804-2209
Phone: (260) 432-5566
Fax: (260) 432-5567
Website:
Authorized official contact:
Name: Iczkovitz, Michael L Doctor of Dental Surgery (DDS)
Phone: (260) 484-9990
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 54000677 | Indiana |
Profile Details
| NPI number | 1558416883 |
|---|---|
| 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 | Jan 25th, 2007 |
| Last updated | Mar 26th, 2009 - about 17 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 | 1558416883 | NPPES |
| Indiana | MEDICAID | 200147450 |
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