| Oral Maxillofacial Surgeons, Ltd. | |
|
1265 Reservoir Ave Cranston RI 02920-6060 | |
| (401) 464-6406 | |
| (401) 464-6466 |
| Full Name | Oral Maxillofacial Surgeons, Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 1265 Reservoir Ave, Cranston, Rhode Island |
| Authorized Official Name and Position | Martin T Elson (PRESIDENT) |
| Authorized Official Contact | 4014646406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Maxillofacial Surgeons, Ltd. 1265 Reservoir Ave Cranston RI 02920-6060 Ph: (401) 464-6406 | Oral Maxillofacial Surgeons, Ltd. 1265 Reservoir Ave Cranston RI 02920-6060 Ph: (401) 464-6406 |
| NPI Number | 1457522005 |
|---|---|
| Provider Enumeration Date | 03/21/2008 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9234387697 |
|---|---|
| Medicare Enrollment ID | O20120911000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457522005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Rhode Island) | Primary |
| Provider Name | Martin T Elson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1518939388 PECOS PAC ID: 8123270345 Enrollment ID: I20121214000010 |
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