# ORAL AND MAXILLOFACIAL SURGERY INNOVATIONS, LLC

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

## Provider details

- **NPI number:** 1225126428
- **Authorized official:** DR. LARRY PEPPER DMD (OWNER)
- **Authorized official phone:** (717) 909-0530

## Contact information

- **Practice address:** 4700 UNION DEPOSIT RD, SUITE 260, HARRISBURG, PA 17111-3774
- **Practice address phone:** (717) 909-3239
- **Practice address fax:** (717) 909-3242
- **Mailing address:** 4700 UNION DEPOSIT RD, SUITE 260, HARRISBURG, PA 17111-3774
- **Mailing address phone:** (717) 909-3239
- **Mailing address fax:** (717) 909-3242

## 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:** 10/11/2006
- **Last updated:** 07/30/2020