# TERRE HAUTE ORAL SURGERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Terre Haute Oral & Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679384929
- **Authorized official:** DR. JAN SLAPNICKA MD, DDS (ORAL SURGEON)
- **Authorized official phone:** (310) 689-6148

## Contact information

- **Practice address:** 3630 S 4TH ST, TERRE HAUTE, IN 47802-5543
- **Practice address phone:** (812) 814-9245
- **Mailing address:** 12651 ROSEBERY ST, CARMEL, IN 46032-7384
- **Mailing address phone:** (310) 689-6148

## 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:** 01/16/2025
- **Last updated:** 01/16/2025