# RICHARDSON ORAL SURGERY AND IMPLANT CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013392463
- **Authorized official:** CAMPBELL BOURLAND DDS, MS (DOCTOR/OWNER)
- **Authorized official phone:** (972) 231-6661

## Contact information

- **Practice address:** 1070 W CAMPBELL RD, SUITE 200, RICHARDSON, TX 75080-2941
- **Practice address phone:** (972) 231-6661
- **Practice address fax:** (972) 231-3161
- **Mailing address:** 1070 W CAMPBELL RD, SUITE 200, RICHARDSON, TX 75080-2941
- **Mailing address phone:** (972) 231-6661
- **Mailing address fax:** (972) 231-3161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22690 | TX | Yes |

## Other

- **Enumeration date:** 07/28/2015
- **Last updated:** 07/28/2015