Facial And Oral Surgery Associates, Pllc | |
1625 Saint Louis Ave Fort Worth TX 76104-7635 | |
(817) 927-1325 | |
(817) 927-1497 |
Full Name | Facial And Oral Surgery Associates, Pllc |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1625 Saint Louis Ave, Fort Worth, Texas |
Authorized Official Name and Position | John P. Stella (PRESIDENT) |
Authorized Official Contact | 8179271325 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Facial And Oral Surgery Associates, Pllc 1625 Saint Louis Ave Fort Worth TX 76104-7635 Ph: (817) 927-1325 | Facial And Oral Surgery Associates, Pllc 1625 Saint Louis Ave Fort Worth TX 76104-7635 Ph: (817) 927-1325 |
NPI Number | 1891918827 |
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Provider Enumeration Date | 04/10/2007 |
Last Update Date | 01/15/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891918827 | NPI | - | NPPES |
8116093 | Other | TX | BCBS-BLUE LINK |
009690101 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Secondary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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