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Organization

SUMMIT ORAL SURGERY CENTER LLC

Active
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Organization

SUMMIT ORAL SURGERY CENTER LLC

Active
Other names
Independence Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL LEE DDS (CENTER ADMIN; BOARD OF MANAGERS)
(816) 271-0110
Entity
Organization

Contact information

Practice address
19921 E JACKSON DR, INDEPENDENCE, MO 64057-1596
(313) 600-2188
Mailing address
19921 E JACKSON DR, INDEPENDENCE, MO 64057-1596
(816) 271-0110

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
04/04/2026
Last updated
08/11/2026
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