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Organization

CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC

Active
Parent organization
CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC
Other names
Dr. Firas Ali, DMD
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC
Authorized official
PAM HARDIEK (INSURANCE/CREDENTIALING)
(217) 540-5100
Entity
Organization

Contact information

Practice address
2633 CHATHAM RD STE A, SPRINGFIELD, IL 62704-4185
(217) 698-8777
(217) 698-8787
Mailing address
2633 CHATHAM RD STE A, SPRINGFIELD, IL 62704-4185
(217) 698-8777
(217) 698-8787

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
09/09/2008
Last updated
09/11/2008
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