# NORTHSHORE ORAL SURGERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Genesis Oral Surgery and Implant Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952095010
- **Authorized official:** DR. MICHAEL ANTHONY GUTHRIE DDS (PRESIDENT)
- **Authorized official phone:** (773) 255-1128

## Contact information

- **Practice address:** 2300 S MICHIGAN AVE STE 100, CHICAGO, IL 60616-2119
- **Practice address phone:** (773) 255-1128
- **Mailing address:** 2300 S MICHIGAN AVE STE 100, CHICAGO, IL 60616-2119
- **Mailing address phone:** (872) 302-5322
- **Mailing address fax:** (872) 282-0337

## 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:** 06/02/2023
- **Last updated:** 09/08/2025