Organization
ELKHART ORAL AND MAXILLOFACIAL SURGERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY S MCBRIDE DDS (OWNER/PARTNER)
(574) 293-8211
Entity
Organization
Contact information
Practice address
117 S NAPPANEE ST, ELKHART, IN 46514-1955
(574) 293-8211
(574) 295-8270
Mailing address
117 S NAPPANEE ST, ELKHART, IN 46514-1955
(574) 293-8211
(574) 295-8270
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12008926
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200310500A
—
IN
Enumeration date
02/05/2008
Last updated
11/15/2017
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