| Texoma Facial And Oral Surgery | |
|
2304 Midwestern Pkwy Suite 102 Wichita Falls TX 76308-2342 | |
| (940) 696-1544 | |
| Not Available |
| Full Name | Texoma Facial And Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2304 Midwestern Pkwy, Wichita Falls, Texas |
| Authorized Official Name and Position | Clark Allen Petersen (OPERATIONS DIRECTOR) |
| Authorized Official Contact | 6184026622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texoma Facial And Oral Surgery 4447 N Central Expy Suite 110, Pmb 434 Dallas TX 75205-4245 Ph: (800) 215-6530 | Texoma Facial And Oral Surgery 2304 Midwestern Pkwy Suite 102 Wichita Falls TX 76308-2342 Ph: (940) 696-1544 |
| NPI Number | 1255710752 |
|---|---|
| Provider Enumeration Date | 05/29/2015 |
| Last Update Date | 05/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255710752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 24871 (Texas) | Primary |
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