Organization
BIRMINGHAM ORAL & MAXILLOFACIAL SURGERY, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY MCNAUGHTON (BILLER)
(486) 474-7002
Entity
Organization
Contact information
Practice address
555 S OLD WOODWARD AVE STE 777, BIRMINGHAM, MI 48009
(248) 647-4700
(248) 647-4730
Mailing address
555 S OLD WOODWARD AVE STE 777, BIRMINGHAM, MI 48009-6618
(248) 647-4700
(248) 647-4730
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901012981
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2990516
—
MI
Enumeration date
05/10/2018
Last updated
07/13/2018
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