Associated Oral and Maxillofacial Surgeons of Peoria, Ltd

NPI #1154357291 in Peoria, Illinois

Provider Information

NPI Number: 1154357291
Entity Type: Organization
Organization Name: Associated Oral and Maxillofacial Surgeons of Peoria, Ltd
Primary Specialty: Dentist - Oral and Maxillofacial Surgery
Enumeration Date: Jun 23, 2006
Last Updated: Nov 5, 2024

Practice Location

Address: 5720 N KNOXVILLE AVE
City: Peoria
State: Illinois
ZIP Code: 61614-4331
Phone: (309) 682-1213

Authorized Official

Name: ROBYN WOLFE
Title: PRACTICE LEADER
Phone: (309) 682-1249

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X	Primary

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