Organization
ST. CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC
Active
Other names
St. Clair Oral and Maxillofacial Surgery PLLC, St. Clair OMS, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS JAMES BOURNIAS DDS (OWNER)
(586) 727-6800
Entity
Organization
Contact information
Practice address
36610 HERITAGE DR, RICHMOND, MI 48062-1937
(586) 727-6880
(586) 727-6880
Mailing address
70 S DEEPLANDS RD, GROSSE POINTE SHORES, MI 48236-2642
(248) 882-3195
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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