| Oral And Maxillofacial Surgery Affiliates Ltd. | |
|
111 S Washington St. Ste 101 Park Ridge IL 60068-4203 | |
| (847) 696-4848 | |
| (847) 696-1609 |
| Full Name | Oral And Maxillofacial Surgery Affiliates Ltd. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 111 S Washington St., Park Ridge, Illinois |
| Authorized Official Name and Position | John Michael Sisto (PRESIDENT) |
| Authorized Official Contact | 8476964848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral And Maxillofacial Surgery Affiliates Ltd. 111 S Washington Ave Ste 101 Park Ridge IL 60068-4203 Ph: (847) 696-4848 | Oral And Maxillofacial Surgery Affiliates Ltd. 111 S Washington St. Ste 101 Park Ridge IL 60068-4203 Ph: (847) 696-4848 |
| NPI Number | 1982822912 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982822912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (Illinois) | Primary |
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