# PREMIER ORAL AND MAXILLOFACIAL SURGERY P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** PREMIER ORAL SURGERY AND DENTAL IMPLANT CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992534168
- **Authorized official:** DR. ABDULKADER HAKIMUDDIN GHADIALI DDS (PRESIDENT)
- **Authorized official phone:** (708) 942-8154

## Contact information

- **Practice address:** 16523 106TH CT UNIT C2, ORLAND PARK, IL 60467-4545
- **Practice address phone:** (708) 942-8154
- **Practice address fax:** (708) 551-0753
- **Mailing address:** 16523 106TH CT UNIT C2, ORLAND PARK, IL 60467-4545
- **Mailing address phone:** (708) 942-8154

## 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:** 07/29/2024
- **Last updated:** 10/09/2024