# NORTH IOWA ORAL SURGERY AND DENTAL IMPLANT CENTER, LLP

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

## Provider details

- **NPI number:** 1215071394
- **Authorized official:** DR. LYELL R. HOGG D.D.S. (OWNER)
- **Authorized official phone:** (641) 424-1656

## Contact information

- **Practice address:** 1530 S MONROE AVE, MASON CITY, IA 50401
- **Practice address phone:** (641) 424-1656
- **Practice address fax:** (641) 424-2219
- **Mailing address:** 1530 S MONROE AVE, MASON CITY, IA 50401
- **Mailing address phone:** (641) 424-1656
- **Mailing address fax:** (641) 424-2219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | IA | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 07778 | IA | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 08489 | IA | — |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 01/04/2018