# SUMMIT ORAL & MAXILLOFACIAL SURGERY PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1811066129
- **Authorized official:** MS. JANE M WINDISCH (BILLING SPECIALIST)
- **Authorized official phone:** (586) 755-9340

## Contact information

- **Practice address:** 29427 RYAN RD, WARREN, MI 48092-2203
- **Practice address phone:** (586) 755-9340
- **Practice address fax:** (586) 755-9341
- **Mailing address:** 29425 RYAN RD, WARREN, MI 48092-2203
- **Mailing address phone:** (586) 755-9340
- **Mailing address fax:** (586) 755-9341

## 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:** 11/08/2006
- **Last updated:** 09/14/2009