Oral Facial Surgery Institute of Illinois P C
NPI #1740697333 in Belleville, Illinois
Provider Information
- NPI Number
- 1740697333
- Entity Type
- Organization
- Organization Name
- Oral Facial Surgery Institute of Illinois P C
- Primary Specialty
- Oral & Maxillofacial Surgery
- Enumeration Date
- Jul 16, 2014
- Last Updated
- Sep 8, 2025
Practice Location
- Address
- 10200 WEST MAIN STREET
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62223
- Phone
- (618) 397-2464
Authorized Official
- Name
- MR. SCOTT E GRAHAM, MHA, FACMPE, FAADOM
- Title
- ADMINISTRATOR
- Phone
- (314) 413-6043
Specialties & Taxonomy Codes
| Specialty |
|---|
| Oral & Maxillofacial Surgery |
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