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Organization
KALAMAZOO ORAL & MAXILLOFACIAL SURGERY, P.C.
Active
Organization
KALAMAZOO ORAL & MAXILLOFACIAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY SIMONELLI (OFFICE MANAGER)
(269) 323-1527
Entity
Organization
Contact information
Practice address
3801 GLENKERRY CT, PORTAGE, MI 49024-0718
(269) 323-1527
(269) 323-1670
Mailing address
3801 GLENKERRY CT, PORTAGE, MI 49024-0718
(269) 323-1527
(269) 323-1670
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
10/13/2006
Last updated
06/02/2015
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