| Advanced Oral Surgery, Pllc | |
|
3855 Burton St Se Ste B Grand Rapids MI 49546-6147 | |
| (616) 369-0360 | |
| (616) 369-0361 |
| Full Name | Advanced Oral Surgery, Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3855 Burton St Se Ste B, Grand Rapids, Michigan |
| Authorized Official Name and Position | Mark Leonard Jesin (MANAGER) |
| Authorized Official Contact | 6163690360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Oral Surgery, Pllc 3855 Burton St Se Ste B Grand Rapids MI 49546-6147 Ph: (616) 369-0360 | Advanced Oral Surgery, Pllc 3855 Burton St Se Ste B Grand Rapids MI 49546-6147 Ph: (616) 369-0360 |
| NPI Number | 1508324732 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 03/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508324732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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