Organization
MIDLAND ORAL & MAXILLOFACIAL SURGERY P.C.
Active
Other names
Mt. Pleasant Oral & Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
SHIANNE BOWERS (FINANCIAL DEPT)
(989) 839-9979
Entity
Organization
Contact information
Practice address
6112 MERLIN CT, MIDLAND, MI 48640
(989) 839-9979
(989) 839-9553
Mailing address
6112 MERLIN CT, MIDLAND, MI 48640-7358
(989) 839-9979
(989) 839-9553
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2847912
—
MI
05
—
2993779
—
MI
05
—
3487124
—
MI
05
—
3487133
—
MI
05
—
4263986
—
MI
05
—
426977
—
MI
05
—
4274282
—
MI
05
—
4274291
—
MI
05
—
4274308
—
MI
05
—
4274317
—
MI
05
—
4285455
—
MI
05
—
4297311
—
MI
Enumeration date
10/04/2005
Last updated
02/17/2020
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