NPI:
1194381640
Provider Name:
BILLY B. LAUN II, DDS, PC
Doing Business As: ORAL & MAXILLOFACIAL SURGERY OF CARBONDALE, INC
Classification:
Dentist - 1223S0112X
Entity Type:
Organization
Specialization: Oral and Maxillofacial Surgery
CLIA Number: 14D2171607
Address:
1111 E WALNUT ST STE B
CARBONDALE, IL
ZIP 62901
Phone:
(618) 529-2571
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BILLY B. LAUN II, DDS, PC is an oral and maxillofacial surgery dentist in Carbondale, IL. 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. BILLY B. LAUN II, DDS, PC NPI is 1194381640. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Oral & Maxillofacial Surgery Of Carbondale, Inc.
The provider's business location address is:
1111 E WALNUT ST STE B
CARBONDALE, IL
ZIP 62901-000
Phone: (618) 529-2571
Fax: (618) 529-2572
The provider's authorized official is Billy B Laun .
The authorized official title is Owner/provider and has the following contact phone number (618) 529-2571.
The CLIA number assigned to this NPI record is 14D2171607 - practitioner other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 5/9/2019 and was last updated on 9/11/2019.