OrganizationActive
Affiliates in Oral & Maxillofacial Surgery Ltd
NPI 1215196290 · Oral and Maxillofacial Surgery (Dentist) · Champaign, IL
Provider details
- NPI number
- 1215196290
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Philip Banghart, President/Oral Surgeon(217) 351-7111
- License
- 019021176 (IL)
Specialties & taxonomies
Dental Providers
Practice location
3112 Village Office Pl
Champaign, IL 61822-7680
Phone: (217) 351-7111
Fax: (217) 351-7282
Approximate (ZIP-level) locationGet directions
Mailing address
3112 Village Office Pl
Champaign, IL 61822-7680
Registry dates
- Enumerated
- 2008-06-05
- Last updated
- 2008-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.