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Organization
TERRE HAUTE ORAL SURGERY LLC
Active
Organization
TERRE HAUTE ORAL SURGERY LLC
Active
Other names
Terre Haute Oral & Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN SLAPNICKA MD, DDS (ORAL SURGEON)
(310) 689-6148
Entity
Organization
Contact information
Practice address
3630 S 4TH ST, TERRE HAUTE, IN 47802-5543
(812) 814-9245
Mailing address
12651 ROSEBERY ST, CARMEL, IN 46032-7384
(310) 689-6148
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
01/16/2025
Last updated
01/16/2025
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