| The Center For Jaw And Facial Surgery, P.c. | |
|
901 Medical Park Dr Suite 200 Effingham IL 62401-2191 | |
| (217) 342-4444 | |
| (217) 347-8928 |
| Full Name | The Center For Jaw And Facial Surgery, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 901 Medical Park Dr, Effingham, Illinois |
| Authorized Official Name and Position | Jay Ivor Swanson (PRESIDENT) |
| Authorized Official Contact | 2173424444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center For Jaw And Facial Surgery, P.c. 901 Medical Park Dr Suite 200 Effingham IL 62401-2191 Ph: (217) 342-4444 | The Center For Jaw And Facial Surgery, P.c. 901 Medical Park Dr Suite 200 Effingham IL 62401-2191 Ph: (217) 342-4444 |
| NPI Number | 1588612386 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 03/04/2013 |
| Medicare PECOS PAC ID | 7911910260 |
|---|---|
| Medicare Enrollment ID | O20060803000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588612386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 019019384 (Illinois) | Primary |
| Provider Name | Jay I Swanson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1811166614 PECOS PAC ID: 7517960297 Enrollment ID: I20110128001063 |
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