# CYPRESS BEND ORAL & MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1346868676
- **Authorized official:** JUSTIN STANFORD DDS (OWNER)
- **Authorized official phone:** (337) 352-2363

## Contact information

- **Practice address:** 106 RUE BASTILLE, LAFAYETTE, LA 70508
- **Practice address phone:** (337) 352-2363
- **Mailing address:** 106 RUE BASTILLE, LAFAYETTE, LA 70508

## Taxonomy

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

## Other

- **Enumeration date:** 07/13/2020
- **Last updated:** 07/13/2020