Organization
ADVANCED ORAL SURGERY, PLLC
Active
Other names
Advanced Oral Surgery and Dental Implant Studio
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LEONARD JESIN DDS (MANAGER)
(616) 369-0360
Entity
Organization
Contact information
Practice address
3855 BURTON ST SE STE B, GRAND RAPIDS, MI 49546-6147
(616) 369-0360
(616) 369-0361
Mailing address
3855 BURTON ST SE STE B, GRAND RAPIDS, MI 49546-6147
(616) 369-0360
(616) 369-0361
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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