| Oral Surgery Of Indiana, Llc | |
|
620 S Tillotson Ave Muncie IN 47304-4448 | |
| (770) 692-1000 | |
| Not Available |
| Full Name | Oral Surgery Of Indiana, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 620 S Tillotson Ave, Muncie, Indiana |
| Authorized Official Name and Position | Tamonia Leonard (CREDENTAILING SPECIALIST) |
| Authorized Official Contact | 6782444844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Surgery Of Indiana, Llc 620 S Tillotson Ave Muncie IN 47304-4448 Ph: (770) 692-1000 | Oral Surgery Of Indiana, Llc 620 S Tillotson Ave Muncie IN 47304-4448 Ph: (770) 692-1000 |
| NPI Number | 1376181347 |
|---|---|
| Provider Enumeration Date | 12/20/2019 |
| Last Update Date | 12/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376181347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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