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Organization
SWEDISHAMERICAN HOSPITAL
Active
Organization
SWEDISHAMERICAN HOSPITAL
Active
Other names
SAH ORAL & MAXILLOFACIAL SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
DON DANIELS (VP)
(815) 966-2084
Entity
Organization
Contact information
Practice address
425 ROXBURY RD, ROCKFORD, IL 61107
(779) 696-7150
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
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
01/09/2017
Last updated
07/12/2018
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