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Organization
SUMMIT ORAL SURGERY CENTER LLC
Active
Organization
SUMMIT ORAL SURGERY CENTER LLC
Active
Other names
Independence Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LEE DDS (CENTER ADMIN; BOARD OF MANAGERS)
(816) 271-0110
Entity
Organization
Contact information
Practice address
19921 E JACKSON DR, INDEPENDENCE, MO 64057-1596
(313) 600-2188
Mailing address
19921 E JACKSON DR, INDEPENDENCE, MO 64057-1596
(816) 271-0110
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/04/2026
Last updated
08/11/2026
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