# LIBERTYVILLE ORAL SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIBERTYVILLE ORAL SURGERY PC
- **Other names:** Libertyville Oral Surgery and Dental Implants
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891477352
- **Legal business name:** LIBERTYVILLE ORAL SURGERY PC
- **Authorized official:** DR. BRYAN VANOVEN DDS (ORAL MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (847) 367-8656

## Contact information

- **Practice address:** 1236 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
- **Practice address phone:** (847) 367-8656
- **Mailing address:** 1236 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
- **Mailing address phone:** (847) 367-8656

## 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:** 08/03/2023
- **Last updated:** 08/03/2023