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Organization

CENTRAL ILLINOIS ORAL AND MAXILLOFACIAL SURGERY, PC

Active
Parent organization
CENTRAL ILLINOIS ORAL AND MAXILLOFACIAL SURGERY, PC
Other names
Champaign Oral Surgery Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL ILLINOIS ORAL AND MAXILLOFACIAL SURGERY, PC
Authorized official
AMY M KROEGER (INSURANCE COORDINATOR)
(217) 540-5100
Entity
Organization

Contact information

Practice address
14 E ANTHONY DR, SUITE C, CHAMPAIGN, IL 61820-2748
(217) 355-2809
(217) 355-5921
Mailing address
14 E ANTHONY DR, SUITE C, CHAMPAIGN, IL 61820-2748
(217) 355-2809
(217) 355-5921

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
12/01/2006
Last updated
08/23/2023
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