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ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA NPI 1780765495


NPI Information

NPI: 1780765495
Provider Name: ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA

Doing Business As: ORAL SURGERY ASSOCIATES PA

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
20 LONG CREEK DR
SOUTH PORTLAND, ME
ZIP 04106
Phone: (207) 772-4063
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ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA is an oral and maxillofacial surgery dentist in South Portland, ME. 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. ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PA NPI is 1780765495. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Oral Surgery Associates Pa.

The provider's business location address is:

20 LONG CREEK DR
SOUTH PORTLAND, ME
ZIP 04106-425
Phone: (207) 772-4063

The provider's authorized official is Mark D Zajkowski .
The authorized official title is Partner/practice Owner and has the following contact phone number (207) 772-4063.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 11/1/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1110700000MEDICAIDMAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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