Provider Demographics
NPI:1881487718
Name:WEST SHORE ORAL SURGERY, PLLC
Entity type:Organization
Organization Name:WEST SHORE ORAL SURGERY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, PAYOR RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-324-3242
Mailing Address - Street 1:200 CUMBERLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5663
Mailing Address - Country:US
Mailing Address - Phone:717-697-6020
Mailing Address - Fax:
Practice Address - Street 1:200 CUMBERLAND PKWY
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5663
Practice Address - Country:US
Practice Address - Phone:717-697-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty