| Lake Michigan Oral & Maxillofacial Surgery Pllc | |
|
3950 Hollywood Rd 290 Saint Joseph MI 49085-9151 | |
| (405) 848-7974 | |
| (405) 848-0033 |
| Full Name | Lake Michigan Oral & Maxillofacial Surgery Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3950 Hollywood Rd, Saint Joseph, Michigan |
| Authorized Official Name and Position | Lisa Keough (CREDENTIALING REP) |
| Authorized Official Contact | 4058487974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Michigan Oral & Maxillofacial Surgery Pllc 3000 United Founders Blvd 237 Oklahoma City OK 73112-3958 Ph: (405) 848-7974 | Lake Michigan Oral & Maxillofacial Surgery Pllc 3950 Hollywood Rd 290 Saint Joseph MI 49085-9151 Ph: (405) 848-7974 |
| NPI Number | 1245544824 |
|---|---|
| Provider Enumeration Date | 08/05/2010 |
| Last Update Date | 08/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245544824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2901018748 (Michigan) | Primary |
John M Kim Dmd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3102 Niles Rd, Saint Joseph, MI 49085 Phone: 269-429-7122 Fax: 269-429-6410 | |
Charles W Howenstine Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3386 Niles Rd, Saint Joseph, MI 49085 Phone: 269-281-8080 | |
Kai Steele Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 455 Upton Dr, Saint Joseph, MI 49085 Phone: 269-983-7888 | |
Smiles On Niles Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2800 Niles Road, Saint Joseph, MI 49085 Phone: 269-429-2511 Fax: 269-429-5130 | |
Timothy Ward Plc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3906 Stonegate Park Ste B, Saint Joseph, MI 49085 Phone: 269-428-2875 Fax: 269-428-4461 | |
Craig C Brown Dmd & John C Luczak Dmd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2525 S Cleveland Ave, Saint Joseph, MI 49085 Phone: 269-429-1587 |