Provider Demographics
NPI:1881808053
Name:ORAL AND MAXILLOFACIAL SURGERY SPECALISTS LTD.
Entity type:Organization
Organization Name:ORAL AND MAXILLOFACIAL SURGERY SPECALISTS LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL & MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-226-8920
Mailing Address - Street 1:4035 MORSAY DR.
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-4871
Mailing Address - Country:US
Mailing Address - Phone:815-226-8920
Mailing Address - Fax:815-226-8928
Practice Address - Street 1:4035 MORSAY DR.
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-4871
Practice Address - Country:US
Practice Address - Phone:815-226-8920
Practice Address - Fax:815-226-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery