Organization
OFS-SHOALS, LLC
Active
Other names
Oral and Facial Surgery of the Shoals
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MCILWAIN DMD, MD (OWNER/ ORAL SURGEON)
(256) 712-5096
Entity
Organization
Contact information
Practice address
154 TITAN DR, FLORENCE, AL 35630-1197
(256) 712-5096
(256) 712-5097
Mailing address
154 TITAN DR, FLORENCE, AL 35630-1197
(256) 712-5096
(256) 712-5097
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
02/09/2024
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