# WACO CENTER FOR ORAL & MAXILLOFACIAL SURGERY PLLC

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

## Provider details

- **NPI number:** 1518664200
- **Authorized official:** LARRY CUNNINGHAM DDS,MD,FACS (OWNER/DDS, MD, FACS)
- **Authorized official phone:** (254) 265-9636

## Contact information

- **Practice address:** 7030 NEW SANGER AVE STE 100, WACO, TX 76712-4073
- **Practice address phone:** (254) 265-9636
- **Mailing address:** 500 E JOHN CARPENTER FWY STE 300, IRVING, TX 75062-3969

## 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:** 02/13/2023
- **Last updated:** 04/09/2025