GREAT LAKES ORAL SURGERY, P.C.
NPI 1174858419
Dentist - Oral and Maxillofacial Surgery in Fulton, NY

Q: What is Great Lakes Oral Surgery, P.C.'s NPI number?

The NPI number for Great Lakes Oral Surgery, P.C. is 1174858419. It was assigned to this organization in the NPPES registry on October 5, 2009.

Q: What is Great Lakes Oral Surgery, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since October 05, 2009

633 W. 3RD ST. S., FULTON, NY 13069(315) 343-6160(315) 343-8556 Get Directions Write a Review

NPPES record last updated: January 31, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Great Lakes Oral Surgery, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES ORAL SURGERY, P.C. (NPI 1174858419) is a healthcare organization registered as an oral and maxillofacial surgery in Fulton, New York and active in the NPI registry since October 2009. The organization lists David A. Macgregor, Owner, as its authorized official.

NPPES Registry Identity

NPI1174858419

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameGREAT LAKES ORAL SURGERY, P.C.

Location Address633 W. 3RD ST. S.Fulton, NY 13069

Mailing Address633 W. 3rd St. S.Fulton, NY 13069 · (315) 343-6160 · Fax (315) 343-8556

Phone(315) 343-6160

Fax(315) 343-8556

Organization SubpartNo

Authorized OfficialDavid A. MacgregorOwner · (315) 343-6160

Enumeration DateOctober 5, 2009

Last NPPES UpdateJanuary 31, 2019

✔ NPI 1174858419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in NY · 051594

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

633 W. 3RD ST. S., Fulton, NY 13069

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Other Identifiers 1

Medicaid03118614NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID A. MACGREGOR D.M.D.

Dentist (Oral and Maxillofacial Surgery)

633 W. 3RD ST. S.
FULTON, NY 13069

Oswego County (315) 343-6160

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Oral Surgery, P.C.'s NPI number?

The NPI number for Great Lakes Oral Surgery, P.C. is 1174858419. It was assigned to this organization in the NPPES registry on October 5, 2009.

Where is Great Lakes Oral Surgery, P.C. located?

Great Lakes Oral Surgery, P.C. is located at 633 W. 3rd St. S., Fulton, NY 13069. The listed phone number is (315) 343-6160.

What is Great Lakes Oral Surgery, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Great Lakes Oral Surgery, P.C. was last updated on January 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.