Organization
ORAL SURGERY P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY PHIPPS (TX COORDINATOR)
(586) 323-1600
Entity
Organization
Contact information
Practice address
51745 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-4451
(586) 323-1600
(586) 323-1644
Mailing address
51745 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-4451
(586) 323-1600
(586) 323-1644
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901019237
MI
Other
Enumeration date
12/19/2014
Last updated
12/19/2014
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