# MIDWEST ORAL AND MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1679761969
- **Authorized official:** MRS. SHEILA M DALY (OFFICE MANAGER)
- **Authorized official phone:** (708) 448-8670

## Contact information

- **Practice address:** 7400 W COLLEGE DR, PALOS HEIGHTS, IL 60463-1155
- **Practice address phone:** (708) 448-8670
- **Practice address fax:** (708) 448-8698
- **Mailing address:** 7400 W COLLEGE DR, PALOS HEIGHTS, IL 60463-1155
- **Mailing address phone:** (708) 448-8670
- **Mailing address fax:** (708) 448-8698

## 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:** 10/11/2007
- **Last updated:** 10/11/2007