Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Center for Oral and Maxillofacial Surgery, PC

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1801000443

Center for Oral and Maxillofacial Surgery, PC is an Oral & Maxillofacial Surgery (D.M.D.) in Belleville, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10200 W Main St Signal Hill Medical Bldg
Belleville, IL 62223-1408
Phone: (618) 397-2464
Fax: (618) 398-4450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 060000298 (IL)

Record details

NPI number1801000443
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Glenn Miller — Oral & Maxillofacial Surgeon · (618) 387-2464
NPI enumeratedMay 10, 2007
Last updated in NPPESJune 3, 2011
Mailing address10200 West Main, Signal Hill Medical Bldg, Belleville, IL 62223

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