Advanced Oral & Maxillofacial Surgery Ltd. | |
533 W North Ave. Suite 200 Elmhurst IL 60126-2100 | |
(630) 941-3400 | |
(630) 941-3421 |
Full Name | Advanced Oral & Maxillofacial Surgery Ltd. |
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Speciality | Dentist |
Location | 533 W North Ave., Elmhurst, Illinois |
Authorized Official Name and Position | Mark Wolf (PRESIDENT) |
Authorized Official Contact | 6309413400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Advanced Oral & Maxillofacial Surgery Ltd. 533 W North Ave. Suite 200 Elmhurst IL 60126-2100 Ph: (630) 941-3400 | Advanced Oral & Maxillofacial Surgery Ltd. 533 W North Ave. Suite 200 Elmhurst IL 60126-2100 Ph: (630) 941-3400 |
NPI Number | 1700956273 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 06/16/2010 |
Medicare PECOS PAC ID | 7810068657 |
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Medicare Enrollment ID | O20080620000587 |
Identifier | Type | State | Issuer |
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1700956273 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 060.003899 (Illinois) | Primary |
Provider Name | Philip L Lin |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1407086416 PECOS PAC ID: 7315241551 Enrollment ID: I20171009001667 |
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