# SOUTHWEST ORAL & MAXILLOFACIAL SURGERY, P.A.

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

## Provider details

- **NPI number:** 1558514588
- **Authorized official:** MRS. KELLE RAE HILL (BUSINESS MANAGER)
- **Authorized official phone:** (972) 644-8500

## Contact information

- **Practice address:** 1001 BUCKINGHAM RD, SUITE 106, RICHARDSON, TX 75081-5850
- **Practice address phone:** (972) 644-8500
- **Practice address fax:** (972) 644-0104
- **Mailing address:** 1001 BUCKINGHAM RD, SUITE 106, RICHARDSON, TX 75081-5850
- **Mailing address phone:** (972) 644-8500
- **Mailing address fax:** (972) 644-0104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 10599 | TX | Yes |

## Other

- **Enumeration date:** 11/04/2008
- **Last updated:** 11/04/2008