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Organization
BREAKWATER ORAL AND MAXILLOFACIAL SURGERY PLLC
Active
Organization
BREAKWATER ORAL AND MAXILLOFACIAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS FAIRFIELD (INSURANCE COORDINATOR)
(231) 220-0500
Entity
Organization
Contact information
Practice address
6207 HARVEY ST STE A, NORTON SHORES, MI 49444-7861
(231) 220-0500
(231) 220-0300
Mailing address
6207 HARVEY ST STE A, NORTON SHORES, MI 49444-7861
(231) 220-0500
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
09/09/2022
Last updated
08/01/2023
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