| Summit Oral Surgery Center Llc | |
|
19921 E Jackson Dr Independence MO 64057-1596 | |
| (313) 600-2188 | |
| Not Available |
| Full Name | Summit Oral Surgery Center Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 19921 E Jackson Dr, Independence, Missouri |
| Authorized Official Name and Position | Michael Lee (ADMINISTRATOR) |
| Authorized Official Contact | 3136002188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Oral Surgery Center Llc 19921 E Jackson Dr Independence MO 64057-1596 Ph: () - | Summit Oral Surgery Center Llc 19921 E Jackson Dr Independence MO 64057-1596 Ph: (313) 600-2188 |
| NPI Number | 1114868957 |
|---|---|
| Provider Enumeration Date | 04/04/2026 |
| Last Update Date | 04/04/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114868957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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