NPI: 1902993819
Provider Name: GREAT LAKES ORAL SURGERY AND IMPLANTS, P.C.
Former Legal Business Name: ORAL AND MAXILLOFACIAL SURGERY, P.C.
Classification: Dentist - 1223S0112X
Entity Type: Organization
Specialization: Oral and Maxillofacial Surgery
Address:
5417GATEWAY CENTRE BLVD.
FLINT, MI
ZIP 48507
Phone: (810) 424-0705
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GREAT LAKES ORAL SURGERY AND IMPLANTS, P.C. is an oral and maxillofacial surgery dentist in Flint, 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. GREAT LAKES ORAL SURGERY AND IMPLANTS, P.C. NPI is 1902993819. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Oral And Maxillofacial Surgery, P.c..
The provider's business location address is:
5417GATEWAY CENTRE BLVD.
FLINT, MI
ZIP 48507-980
Phone: (810) 424-0705
Fax: (810) 424-0750
The provider's authorized official is Michael S. Frey .
The authorized official title is Owner/president and has the following contact phone number (810) 424-0705.
The enumeration date for this NPI number is 10/10/2006 and was last updated on 8/11/2014.