| Fox River Oral And Maxillofacial Surgery | |
|
1500 Carlemont Dr Suite #f Crystal Lake IL 60014-1833 | |
| (815) 356-3977 | |
| Not Available |
| Full Name | Fox River Oral And Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1500 Carlemont Dr, Crystal Lake, Illinois |
| Authorized Official Name and Position | Michael Edwin Jones (PRESIDENT) |
| Authorized Official Contact | 8153563977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fox River Oral And Maxillofacial Surgery 1500 Carlemont Dr Suite #f Crystal Lake IL 60014-1833 Ph: (815) 356-3977 | Fox River Oral And Maxillofacial Surgery 1500 Carlemont Dr Suite #f Crystal Lake IL 60014-1833 Ph: (815) 356-3977 |
| NPI Number | 1013028398 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013028398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 21002105 (Illinois) | Primary |
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