# MGM19 INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** McKnight Oral, Maxillofacial and Dental Implant Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215579008
- **Authorized official:** DR. MATTHEW GREGORY MCKNIGHT DDS, MD (OWNER/PRESIDENT)
- **Authorized official phone:** (630) 377-7077

## Contact information

- **Practice address:** 605 COURTYARD DR, SAINT CHARLES, IL 60174-1463
- **Practice address phone:** (630) 377-7077
- **Mailing address:** 605 COURTYARD DR, SAINT CHARLES, IL 60174-1463
- **Mailing address phone:** (630) 377-7077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2019
- **Last updated:** 03/12/2024