Provider Demographics
NPI:1013680925
Name:ORAL & MAXILLOFACIAL SURGEONS INC
Entity Type:Organization
Organization Name:ORAL & MAXILLOFACIAL SURGEONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCABE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-517-2100
Mailing Address - Street 1:4646 NANTUCKETT DR STE A
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3194
Mailing Address - Country:US
Mailing Address - Phone:419-517-2100
Mailing Address - Fax:419-517-2105
Practice Address - Street 1:725 S SHOOP AVE STE G01
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1702
Practice Address - Country:US
Practice Address - Phone:419-517-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORAL & MAXILLOFACIAL SURGEONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty