Organization
OMFS PRACTICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR H ESCOBAR DDS (PRESIDENT)
(217) 366-1246
Entity
Organization
Contact information
Practice address
2917 CROSSING CT STE A, CHAMPAIGN, IL 61822-6185
(217) 366-1246
Mailing address
2917 CROSSING CT STE A, CHAMPAIGN, IL 61822-6185
(217) 366-1246
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021.002026
IL
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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