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Organization

NORTHSHORE ORAL SURGERY CENTER

Active
Other names
Genesis Oral Surgery and Implant Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ANTHONY GUTHRIE DDS (PRESIDENT)
(773) 255-1128
Entity
Organization

Contact information

Practice address
2300 S MICHIGAN AVE STE 100, CHICAGO, IL 60616-2119
(773) 255-1128
Mailing address
2300 S MICHIGAN AVE STE 100, CHICAGO, IL 60616-2119
(872) 302-5322
(872) 282-0337

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
06/02/2023
Last updated
09/08/2025
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