# KALAMAZOO ORAL & MAXILLOFACIAL SURGERY, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1265522262
- **Authorized official:** MS. NANCY SIMONELLI (OFFICE MANAGER)
- **Authorized official phone:** (269) 323-1527

## Contact information

- **Practice address:** 3801 GLENKERRY CT, PORTAGE, MI 49024-0718
- **Practice address phone:** (269) 323-1527
- **Practice address fax:** (269) 323-1670
- **Mailing address:** 3801 GLENKERRY CT, PORTAGE, MI 49024-0718
- **Mailing address phone:** (269) 323-1527
- **Mailing address fax:** (269) 323-1670

## 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:** 10/13/2006
- **Last updated:** 06/02/2015