# BIRMINGHAM ORAL & MAXILLOFACIAL SURGERY, PLC

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

## Provider details

- **NPI number:** 1598255044
- **Authorized official:** BEVERLY MCNAUGHTON (BILLER)
- **Authorized official phone:** (486) 474-7002

## Contact information

- **Practice address:** 555 S OLD WOODWARD AVE STE 777, BIRMINGHAM, MI 48009
- **Practice address phone:** (248) 647-4700
- **Practice address fax:** (248) 647-4730
- **Mailing address:** 555 S OLD WOODWARD AVE STE 777, BIRMINGHAM, MI 48009-6618
- **Mailing address phone:** (248) 647-4700
- **Mailing address fax:** (248) 647-4730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2901012981 | MI | Yes |

## Other

- **Enumeration date:** 05/10/2018
- **Last updated:** 07/13/2018