# ELKHART ORAL AND MAXILLOFACIAL SURGERY INC.

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

## Provider details

- **NPI number:** 1891973541
- **Authorized official:** DR. JEFFREY S MCBRIDE DDS (OWNER/PARTNER)
- **Authorized official phone:** (574) 293-8211

## Contact information

- **Practice address:** 117 S NAPPANEE ST, ELKHART, IN 46514-1955
- **Practice address phone:** (574) 293-8211
- **Practice address fax:** (574) 295-8270
- **Mailing address:** 117 S NAPPANEE ST, ELKHART, IN 46514-1955
- **Mailing address phone:** (574) 293-8211
- **Mailing address fax:** (574) 295-8270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 12008926 | IN | Yes |

## Other

- **Enumeration date:** 02/05/2008
- **Last updated:** 11/15/2017