Organization
MILL CREEK ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK L BILLY D.D.S. (PRESIDENT)
(330) 792-2501
Entity
Organization
Contact information
Practice address
5437 MAHONING AVE STE 12, AUSTINTOWN, OH 44515-2421
(330) 792-2501
(330) 792-9249
Mailing address
5437 MAHONING AVE, SUITE 12, AUSTINTOWN, OH 44515-2437
(330) 792-2501
(330) 792-9249
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
204E0000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102638
—
OH
Enumeration date
02/27/2007
Last updated
01/23/2012
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