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Organization
ORAL & MAXILLOFACIAL SURGERY OF TYLER, PC
Active
Organization
ORAL & MAXILLOFACIAL SURGERY OF TYLER, PC
Active
Other names
Olympic Plaza Oral & Maxillofacial Surgery Assoc.
Organization subpart
No
Provider details
NPI number
Authorized official
JERRI G. GRACE (OFFICE MANAGER)
(903) 595-5186
Entity
Organization
Contact information
Practice address
700 OLYMPIC PLAZA CIR STE 412, TYLER, TX 75701-1952
(903) 595-5186
(903) 595-5240
Mailing address
700 OLYMPIC PLAZA CIR STE 412, TYLER, TX 75701-1952
(903) 595-5186
(903) 595-5240
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10456 & 17107
TX
Other
Enumeration date
11/15/2006
Last updated
07/16/2008
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