Organization
LIBERTYVILLE ORAL SURGERY PC
Active
Parent organization
LIBERTYVILLE ORAL SURGERY PC
Other names
Libertyville Oral Surgery and Dental Implants
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIBERTYVILLE ORAL SURGERY PC
Authorized official
DR. BRYAN VANOVEN DDS (ORAL MAXILLOFACIAL SURGEON)
(847) 367-8656
Entity
Organization
Contact information
Practice address
1236 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
(847) 367-8656
Mailing address
1236 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
(847) 367-8656
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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