OrganizationActive
Center for Oral and Maxillofacial Surgery, P.C.
NPI 1801000443 · Oral & Maxillofacial Surgery (D.M.D.) · Belleville, IL
Provider details
- NPI number
- 1801000443
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Glenn Miller, Oral & Maxillofacial Surgeon(618) 387-2464
- License
- 060000298 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10200 W Main St
Signal Hill Medical Bldg
Belleville, IL 62223-1408
Phone: (618) 397-2464
Fax: (618) 398-4450
Approximate (ZIP-level) locationGet directions
Mailing address
10200 West Main
Belleville, IL 62223
Registry dates
- Enumerated
- 2007-05-10
- Last updated
- 2011-06-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.