MIDWEST ORAL AND MAXILLOFACIAL SURGERY P C is an oral and maxillofacial surgery dentist in Fort Wayne, IN. 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. MIDWEST ORAL AND MAXILLOFACIAL SURGERY P C NPI is 1558416883. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
7230 ENGLE RD
SUITE 301
FORT WAYNE, IN
ZIP 46804-209
Phone: (260) 432-5566
Fax: (260) 432-5567
The provider's authorized official is Michael L Iczkovitz .
The authorized official title is President and has the following contact phone number (260) 484-9990.
The enumeration date for this NPI number is 1/25/2007 and was last updated on 3/26/2009.