PREMIER ORAL SURGERY AND IMPLANTOLOGY PLLC NPI 1972269512

NPI Information

  • NPI: 1972269512
  • Provider Name: PREMIER ORAL SURGERY AND IMPLANTOLOGY PLLC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 209 HARVARD ST STE 307
    BROOKLINE, MA
    ZIP 02446
  • Phone: (617) 468-5110

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NPI Details

PREMIER ORAL SURGERY AND IMPLANTOLOGY PLLC is an oral and maxillofacial surgery dentist in Brookline, MA. 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. PREMIER ORAL SURGERY AND IMPLANTOLOGY PLLC NPI is 1972269512. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

209 HARVARD ST STE 307
BROOKLINE, MA
ZIP 02446-005
Phone: (617) 468-5110
Fax: (617) 468-5111

The provider's authorized official is Chi Young Kim .
The authorized official title is Dds and has the following contact phone number (646) 784-4737.

The enumeration date for this NPI number is 11/9/2021 and was last updated on 11/9/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 3/30/2025

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