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

Great Lakes Oral Surgery, PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1174858419

Great Lakes Oral Surgery, PC is an Oral and Maxillofacial Surgery (Dentist) in Fulton, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

633 W 3rd St S
Fulton, NY 13069
Phone: (315) 343-6160
Fax: (315) 343-8556
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 051594 (NY)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X

Record details

NPI number1174858419
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Macgregor — Owner · (315) 343-6160
NPI enumeratedOctober 5, 2009
Last updated in NPPESJanuary 31, 2019
Mailing address633 W. 3rd St. S., Fulton, NY 13069

Other providers in Fulton