# NORTHWEST ORAL & MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1831356542
- **Authorized official:** MRS. DONNA K KOTSIOS (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (281) 296-9562

## Contact information

- **Practice address:** 4185 TECHNOLOGY FOREST BLVD, SUITE 100, THE WOODLANDS, TX 77381-2006
- **Practice address phone:** (281) 296-9562
- **Practice address fax:** (281) 296-9774
- **Mailing address:** 4185 TECHNOLOGY FOREST BLVD, SUITE 120, THE WOODLANDS, TX 77381-2006
- **Mailing address phone:** (281) 296-9562
- **Mailing address fax:** (281) 296-9774

## 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:** 05/20/2008
- **Last updated:** 05/15/2013