Organization
ORAL AND MAXILLOFACIAL SURGERY CENTER OF LAFAYETTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY A JAMES (OFFICE MANAGER)
(765) 446-8808
Entity
Organization
Contact information
Practice address
2020 UNION STREET, SUITE 200, LAFAYETTE, IN 47904
(765) 446-8808
(765) 446-9567
Mailing address
2020 UNION STREET, SUITE 200, LAFAYETTE, IN 47904
(765) 446-8808
(765) 446-9567
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/13/2006
Last updated
02/27/2009
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