Western Lake Erie Oms Ltd.

NPI #1538380662 in Sylvania, Ohio

Provider Information

NPI Number
1538380662
Entity Type
Organization
Organization Name
Western Lake Erie Oms Ltd.
Primary Specialty
Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date
May 2, 2007
Last Updated
Jul 31, 2019

Practice Location

Address
5690 MONROE ST
State
Ohio
ZIP Code
43560-2736
Phone
(419) 479-3939

Authorized Official

Name
STEPHEN MARK SHALL, D.D.S.
Title
PRESIDENT
Phone
(419) 479-3939

Specialties & Taxonomy Codes

Specialty
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery
Clinic/Center - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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