Provider Demographics
NPI:1033299052
Name:OAKLAND ORAL SURGERY ASSOCIATES
Entity Type:Organization
Organization Name:OAKLAND ORAL SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:586-323-7700
Mailing Address - Street 1:42051 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3143
Mailing Address - Country:US
Mailing Address - Phone:586-323-7700
Mailing Address - Fax:586-323-7707
Practice Address - Street 1:42051 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3143
Practice Address - Country:US
Practice Address - Phone:586-323-7700
Practice Address - Fax:586-323-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty