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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

EDISON LAKES ORAL SURGERY, P.C.

Active Organization

EDISON LAKES ORAL SURGERY, P.C. is a Oral and Maxillofacial Surgery Clinic organization located in SOUTH BEND, Indiana. NPI 1881887065 is currently active in the NPPES registry. Verify at CMS.

Oral and Maxillofacial Surgery Clinic · SOUTH BEND, IN

Registration Details

NPI Number
1881887065
Provider Type
Organization
NPI Issued
Aug 22, 2007 (18.796346683301 yrs)
Last Updated
May 6, 2024
License
12010802A (IN)

Practice Information

Address
3367 DOUGLAS RD
SOUTH BEND, IN, 466351779
Browse IN providers · Browse ZIP 46635
Phone
5742728823
Fax
5742771837
Primary Specialty
Oral and Maxillofacial Surgery Clinic
261QS0112X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.