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Organization
VISION SURGICAL ARTS, LLC
Active
Organization
VISION SURGICAL ARTS, LLC
Active
Other names
Oral Facial Surgery Institute
Organization subpart
No
Provider details
NPI number
Authorized official
LACY WILSON (BUSINESS MANAGER)
(314) 251-6725
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD STE 16A, SAINT LOUIS, MO 63141-8239
(314) 251-6725
Mailing address
621 S NEW BALLAS RD STE 16A, SAINT LOUIS, MO 63141-8239
(314) 251-6725
(314) 251-6726
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
03/04/2024
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