| Northwest Oral Surgeons Pc | |
|
601a W Us Hwy 30 Schererville IN 46375-2656 | |
| (219) 322-0501 | |
| (219) 322-0577 |
| Full Name | Northwest Oral Surgeons Pc |
|---|---|
| Speciality | Dentist |
| Location | 601a W Us Hwy 30, Schererville, Indiana |
| Authorized Official Name and Position | Paul L Wolf (OFFICER) |
| Authorized Official Contact | 2193220501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Oral Surgeons Pc 601a W Us Hwy 30 Schererville IN 46375-2656 Ph: (219) 322-0501 | Northwest Oral Surgeons Pc 601a W Us Hwy 30 Schererville IN 46375-2656 Ph: (219) 322-0501 |
| NPI Number | 1134100902 |
|---|---|
| Provider Enumeration Date | 11/09/2005 |
| Last Update Date | 08/28/2007 |
| Medicare PECOS PAC ID | 9032178199 |
|---|---|
| Medicare Enrollment ID | O20041005001186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134100902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 54000342A (Indiana) | Primary |
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