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Organization
CENTRAL ILLINOIS ORAL AND MAXILLOFACIAL SURGERY, PC
Active
Organization
CENTRAL ILLINOIS ORAL AND MAXILLOFACIAL SURGERY, PC
Active
Parent organization
CENTRAL ILLINOIS ORAL AND MAXILLOFACIAL SURGERY, PC
Other names
Central Illinois Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL ILLINOIS ORAL AND MAXILLOFACIAL SURGERY, PC
Authorized official
AMY KROEGER (INS COODINATOR)
(217) 540-5100
Entity
Organization
Contact information
Practice address
1200 NETWORK CENTRE DR, SUITE B, EFFINGHAM, IL 62401-4637
(217) 540-5800
(217) 342-2557
Mailing address
1200 NETWORK CENTRE DR, SUITE B, EFFINGHAM, IL 62401-4637
(217) 540-5800
(217) 342-2557
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019-024942
IL
Other
Enumeration date
01/08/2007
Last updated
06/29/2023
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