Organization
WESTERN LAKE ERIE OMS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY VORE (PRACTICE ADMINISTRATOR)
(734) 243-9160
Entity
Organization
Contact information
Practice address
876 STEWART RD, #3, MONROE, MI 48162-5345
(734) 243-9160
(734) 243-6393
Mailing address
876 STEWART RD, #3, MONROE, MI 48162-5345
(734) 243-9160
(734) 243-6393
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
MI
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2015
Last updated
07/31/2019
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