NORTHEAST ORAL AND MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in Gahanna, OH. 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. NORTHEAST ORAL AND MAXILLOFACIAL SURGERY NPI is 1790860153. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
463 WATERBURY COURT
SUITE A
GAHANNA, OH
ZIP 43230
Phone: (614) 471-6600
Fax: (614) 471-6660
The provider's authorized official is Bruce Allen Fraser .
The authorized official title is Owner and has the following contact phone number (614) 471-6600.
The CLIA number assigned to this NPI record is 36D1017621 - physician office with a certificate type of Certificate of Compliance.
The enumeration date for this NPI number is 10/26/2006 and was last updated on 8/22/2020.