Organization
NORTHWEST ORAL & MAXILLOFACIAL SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW E GAUTHIER DDS (ORAL SURGEON)
(847) 392-6220
Entity
Organization
Contact information
Practice address
1600 W CENTRAL RD, ARLINGTON HEIGHTS, IL 60005
(847) 392-6220
(847) 392-6236
Mailing address
1600 W CENTRAL RD, ARLINGTON HEIGHTS, IL 60005
(847) 392-6220
(847) 392-6236
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019015876
IL
122300000X
Dentist
Primary
019016047
IL
122300000X
Dentist
019019734
IL
122300000X
Dentist
019025795
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021001087
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021001157
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021001407
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021002123
IL
Other
Enumeration date
03/27/2007
Last updated
10/13/2011
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