# CENTER FOR FACIAL ORAL & IMPLANT SURGERY PA

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

## Provider details

- **NPI number:** 1700188372
- **Authorized official:** GREGORY P HATZIS DDS, MD (OWNER)
- **Authorized official phone:** (903) 315-3813

## Contact information

- **Practice address:** 705 E MARSHALL AVE, 4003, LONGVIEW, TX 75601-5573
- **Practice address phone:** (903) 315-3810
- **Practice address fax:** (903) 315-1937
- **Mailing address:** 705 E MARSHALL AVE, 4003, LONGVIEW, TX 75601
- **Mailing address phone:** (903) 315-3810
- **Mailing address fax:** (903) 315-1937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 12/02/2010
- **Last updated:** 05/18/2011