Organization
MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY A KAMELCHUK D.D.S., M.D. (DDS MD)
(256) 882-3312
Entity
Organization
Contact information
Practice address
1107 GLENEAGLES DR SW, HUNTSVILLE, AL 35801-6405
(256) 882-3312
(256) 882-9472
Mailing address
1107 GLENEAGLES DR SW, HUNTSVILLE, AL 35801-6405
(256) 882-3312
(256) 882-9472
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2007
Last updated
01/29/2008
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