Organization
ORAL SURGERY OFFICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BRIAN COATES D.D.S. (CO-OWNER)
(765) 447-0525
Entity
Organization
Contact information
Practice address
2204 SCOTT ST, LAFAYETTE, IN 47904-2933
(765) 447-0525
(765) 447-5815
Mailing address
2204 SCOTT ST, LAFAYETTE, IN 47904-2933
(765) 447-0525
(765) 447-5815
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232750A
—
IN
Enumeration date
06/02/2005
Last updated
07/21/2022
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