LAKE MICHIGAN ORAL & MAXILLOFACIAL SURGERY PLLC is an oral and maxillofacial surgery dentist in Saint Joseph, MI. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. LAKE MICHIGAN ORAL & MAXILLOFACIAL SURGERY PLLC NPI is 1245544824. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
3950 HOLLYWOOD RD
290
SAINT JOSEPH, MI
ZIP 49085-151
Phone: (405) 848-7974
Fax: (405) 848-0033
The provider's authorized official is Lisa Keough .
The authorized official title is Credentialing Rep and has the following contact phone number (405) 848-7974.
The enumeration date for this NPI number is 8/5/2010 and was last updated on 8/5/2010.