Organization
BREAKWATER ORAL AND MAXILLOFACIAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS FAIRFIELD (INSURANCE COORDINATOR)
(231) 220-0500
Entity
Organization
Contact information
Practice address
6207 HARVEY ST STE A, NORTON SHORES, MI 49444-7861
(231) 220-0500
(231) 220-0300
Mailing address
6207 HARVEY ST STE A, NORTON SHORES, MI 49444-7861
(231) 220-0500
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/09/2022
Last updated
08/01/2023
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