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Organization
MIDWESTERN ORAL SURGERY ASSOCIATES, PLLC
Active
Organization
MIDWESTERN ORAL SURGERY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY REIDER (PRESIDENT MIDWESTERN CLINICAL OPS.)
(313) 582-8150
Entity
Organization
Contact information
Practice address
5050 SCHAEFER RD, DEARBORN, MI 48126-3249
(313) 582-8150
(313) 582-6015
Mailing address
5050 SCHAEFER RD, DEARBORN, MI 48126-3249
(313) 582-8150
(313) 582-6015
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
N/A
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
N/A
—
Other
Enumeration date
05/08/2006
Last updated
05/08/2017
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