| Southwest Oral & Maxillofacial Surgery, P.a. | |
|
1001 Buckingham Rd Suite 106 Richardson TX 75081-5850 | |
| (972) 644-8500 | |
| (972) 644-0104 |
| Full Name | Southwest Oral & Maxillofacial Surgery, P.a. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1001 Buckingham Rd, Richardson, Texas |
| Authorized Official Name and Position | Kelle Rae Hill (BUSINESS MANAGER) |
| Authorized Official Contact | 9726448500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Oral & Maxillofacial Surgery, P.a. 1001 Buckingham Rd Suite 106 Richardson TX 75081-5850 Ph: (972) 644-8500 | Southwest Oral & Maxillofacial Surgery, P.a. 1001 Buckingham Rd Suite 106 Richardson TX 75081-5850 Ph: (972) 644-8500 |
| NPI Number | 1558514588 |
|---|---|
| Provider Enumeration Date | 11/04/2008 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558514588 | NPI | - | NPPES |
| 10599 | Other | TX | TEXAS LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10599 (Texas) | Primary |
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