| Oral & Maxillofacial Surgery Of Abilene Pllc | |
|
1904 Pine St Ste 1d Abilene TX 79601-2450 | |
| (325) 232-8939 | |
| (325) 232-8943 |
| Full Name | Oral & Maxillofacial Surgery Of Abilene Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1904 Pine St Ste 1d, Abilene, Texas |
| Authorized Official Name and Position | Ryan Green (PRESIDENT) |
| Authorized Official Contact | 3252328939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral & Maxillofacial Surgery Of Abilene Pllc 1904 Pine St Ste 1d Abilene TX 79601-2450 Ph: (325) 232-8939 | Oral & Maxillofacial Surgery Of Abilene Pllc 1904 Pine St Ste 1d Abilene TX 79601-2450 Ph: (325) 232-8939 |
| NPI Number | 1104167055 |
|---|---|
| Provider Enumeration Date | 03/01/2013 |
| Last Update Date | 03/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104167055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 24237 (Texas) | Primary |
| 174400000X | Specialist | N4439 (Texas) | Secondary |
| 208600000X | Surgery | N4439 (Texas) | Secondary |
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