# GRAYSLAKE ORAL AND MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1871767780
- **Authorized official:** DR. JEFFREY MARLIN BABIUK I D.D.S. (PRESIDENT)
- **Authorized official phone:** (847) 548-8800

## Contact information

- **Practice address:** 115 COMMERCE DR, SUITE D, GRAYSLAKE, IL 60030-7812
- **Practice address phone:** (847) 548-8800
- **Practice address fax:** (847) 548-8802
- **Mailing address:** 115 COMMERCE DR, SUITE D, GRAYSLAKE, IL 60030-7812
- **Mailing address phone:** (847) 548-8800
- **Mailing address fax:** (847) 548-8802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 019-022879 | IL | Yes |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 04/22/2008