Provider Demographics
NPI:1336659747
Name:DR'S ECKSTEIN, OLEKSY & GILE
Entity Type:Organization
Organization Name:DR'S ECKSTEIN, OLEKSY & GILE
Other - Org Name:CENTER FOR ORAL & FACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MD
Authorized Official - Phone:619-588-4011
Mailing Address - Street 1:306 WALNUT AVE STE 26
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4980
Mailing Address - Country:US
Mailing Address - Phone:619-588-4011
Mailing Address - Fax:
Practice Address - Street 1:306 WALNUT AVE STE 26
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4980
Practice Address - Country:US
Practice Address - Phone:619-588-4011
Practice Address - Fax:619-588-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty