# AOSDI, GLENN J MAKOWSKI, DMD, MD, PC

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

## Provider details

- **NPI number:** 1851618847
- **Authorized official:** DR. GLENN MAKOWSKI DMD, MD (OWNER, ORAL MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (417) 623-2000

## Contact information

- **Practice address:** 2602 CUNNINGHAM AVE, JOPLIN, MO 64804-1542
- **Practice address phone:** (417) 623-2000
- **Practice address fax:** (417) 623-7948
- **Mailing address:** 2602 CUNNINGHAM AVE, JOPLIN, MO 64804-1542
- **Mailing address phone:** (417) 623-2000
- **Mailing address fax:** (417) 623-7948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 04/29/2010
- **Last updated:** 04/29/2010