| Maxillofacial And Facial Aesthetic Surgery | |
|
426 S 3rd St Geneva IL 60134-2708 | |
| (630) 232-9090 | |
| (630) 232-9094 |
| Full Name | Maxillofacial And Facial Aesthetic Surgery |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 426 S 3rd St, Geneva, Illinois |
| Authorized Official Name and Position | Kevin Ray Haddle (PHYSICIAN OWNER) |
| Authorized Official Contact | 6302329090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maxillofacial And Facial Aesthetic Surgery 426 S 3rd St Geneva IL 60134-2708 Ph: (630) 232-9090 | Maxillofacial And Facial Aesthetic Surgery 426 S 3rd St Geneva IL 60134-2708 Ph: (630) 232-9090 |
| NPI Number | 1992978852 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 04/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992978852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Illinois) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | (Illinois) | Primary |
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