Organization
INSTITUTE OF JAW AND FACIAL SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD N SUNDHEIMER D.M.D. (PRESIDENT)
(330) 493-1605
Entity
Organization
Contact information
Practice address
4181 HOLIDAY ST NW, CANTON, OH 44718-2531
(330) 493-1605
(330) 493-9308
Mailing address
4181 HOLIDAY ST NW, CANTON, OH 44718-2531
(330) 493-1605
(330) 493-9308
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0524534
—
OH
05
—
0600433
—
OH
05
—
0733255
—
OH
Enumeration date
02/08/2006
Last updated
04/18/2012
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