| Organization Name: | MILL CREEK ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC |
| NPI Number: | 1063549236 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK L BILLY (PRESIDENT) |
| Mailing Address: | 5437 Mahoning Ave Ste 12 Austintown |
| State: | OH US |
| Postal Code: | 445152421 |
| Phone Number: | 3307922501 |
| Fax Number: | 3307929249 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 01/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 204E0000X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |