# MILL CREEK ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063549236
- **Authorized official:** DR. MARK L BILLY D.D.S. (PRESIDENT)
- **Authorized official phone:** (330) 792-2501

## Contact information

- **Practice address:** 5437 MAHONING AVE STE 12, AUSTINTOWN, OH 44515-2421
- **Practice address phone:** (330) 792-2501
- **Practice address fax:** (330) 792-9249
- **Mailing address:** 5437 MAHONING AVE, SUITE 12, AUSTINTOWN, OH 44515-2437
- **Mailing address phone:** (330) 792-2501
- **Mailing address fax:** (330) 792-9249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 204E0000X | OH | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 01/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2102638 | — | OH |