North Suburban Oral Surgery, Ltd

NPI #1063695104 in Northbrook, Illinois

Provider Information

NPI Number
1063695104
Entity Type
Organization
Organization Name
North Suburban Oral Surgery, Ltd
Primary Specialty
Dentist - Oral and Maxillofacial Surgery
Enumeration Date
Dec 12, 2007
Last Updated
Dec 12, 2007

Practice Location

Address
1240 MEADOW RD
Address 2
SUITE 300
ZIP Code
60062-8300
Phone
(847) 272-9516

Authorized Official

Name
DR. WILLIAM L. NICKEL, DDS
Title
PRESIDENT
Phone
(847) 272-9516

Specialties & Taxonomy Codes

Specialty
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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