Richardson Oral Surgery And Implant Center Pllc | |
1070 W Campbell Rd Suite 200 Richardson TX 75080-2941 | |
(972) 231-6661 | |
(972) 231-3161 |
Full Name | Richardson Oral Surgery And Implant Center Pllc |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1070 W Campbell Rd, Richardson, Texas |
Authorized Official Name and Position | Campbell Bourland (DOCTOR/OWNER) |
Authorized Official Contact | 9722316661 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Richardson Oral Surgery And Implant Center Pllc 1070 W Campbell Rd Suite 200 Richardson TX 75080-2941 Ph: (972) 231-6661 | Richardson Oral Surgery And Implant Center Pllc 1070 W Campbell Rd Suite 200 Richardson TX 75080-2941 Ph: (972) 231-6661 |
NPI Number | 1013392463 |
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Provider Enumeration Date | 07/28/2015 |
Last Update Date | 07/28/2015 |
Identifier | Type | State | Issuer |
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1013392463 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22690 (Texas) | Primary |
Jay L. Nutt & C. Fred Pietsch, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1231 E Belt Line Rd, Suite 103, Richardson, TX 75081 Phone: 972-690-8617 Fax: 972-690-6423 | |