Provider Demographics
NPI:1932965365
Name:JAMES APPIAH ORAL MAXILLOFACIAL SURGERY
Entity Type:Organization
Organization Name:JAMES APPIAH ORAL MAXILLOFACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:APPIAH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-240-9177
Mailing Address - Street 1:14 W SUPERIOR ST APT 1404
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3898
Mailing Address - Country:US
Mailing Address - Phone:908-240-9177
Mailing Address - Fax:
Practice Address - Street 1:5666 E STATE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2425
Practice Address - Country:US
Practice Address - Phone:908-240-9177
Practice Address - Fax:404-420-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery