# CADILLAC ORAL SURGERY ASSOC

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

## Provider details

- **NPI number:** 1588618912
- **Authorized official:** SHEILA S. VANDERHOOF (OFFICE MANAGER)
- **Authorized official phone:** (231) 775-1268

## Contact information

- **Practice address:** 855 S CARMEL ST, CADILLAC, MI 49601-2344
- **Practice address phone:** (231) 775-1268
- **Practice address fax:** (231) 775-1190
- **Mailing address:** 855 S CARMEL ST, CADILLAC, MI 49601-2383
- **Mailing address phone:** (231) 775-1268
- **Mailing address fax:** (231) 775-1190

## 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:** 05/20/2006
- **Last updated:** 12/07/2012