| Midwest Oral And Maxillofacial Surgery P C | |
|
3303 Trier Rd Fort Wayne IN 46815-4768 | |
| (260) 484-9990 | |
| (260) 484-6573 |
| Full Name | Midwest Oral And Maxillofacial Surgery P C |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3303 Trier Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Michael L. Iczkovitz (PRESIDENT) |
| Authorized Official Contact | 2604849990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Oral And Maxillofacial Surgery P C 3303 Trier Rd Fort Wayne IN 46815-4768 Ph: (260) 484-9990 | Midwest Oral And Maxillofacial Surgery P C 3303 Trier Rd Fort Wayne IN 46815-4768 Ph: (260) 484-9990 |
| NPI Number | 1598781106 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 10/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598781106 | NPI | - | NPPES |
| 200147450 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 54000677 (Indiana) | Primary |
Glogas Family Dentistry, L.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 919 Florence Ave, Fort Wayne, IN 46808 Phone: 260-426-8805 Fax: 260-424-1028 | |
Valerie E Lake, Dds, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6211 Covington Rd, Fort Wayne, IN 46804 Phone: 260-432-1579 Fax: 260-432-4540 | |
Prime Dental Care Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 435 W Coliseum Blvd, Fort Wayne, IN 46805 Phone: 260-263-6200 | |
Periodontics Limited Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7750 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-432-0577 Fax: 260-432-0578 | |
Purdue University Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2101 East Coliseum Boulevard, Neff Hall Room 109, Fort Wayne, IN 46805 Phone: 260-481-6575 Fax: 260-481-4162 | |
Summit City Smiles Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1330 E State Blvd, Fort Wayne, IN 46805 Phone: 260-484-5614 | |
Harrison Dental Group Iii Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10506 Coldwater Rd, Fort Wayne, IN 46845 Phone: 260-747-4747 |