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Organization
LAKE JACKSON ORAL AND MAXILLOFACIAL SURGERY, PLLC
Active
Organization
LAKE JACKSON ORAL AND MAXILLOFACIAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN PHILLIPS DDS (PROVIDER)
(979) 299-6878
Entity
Organization
Contact information
Practice address
103 ABNER JACKSON PKWY, LAKE JACKSON, TX 77566-5163
(979) 299-6878
(979) 299-6166
Mailing address
103 ABNER JACKSON PKWY, LAKE JACKSON, TX 77566-5163
(979) 299-6878
(979) 299-6166
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16829
TX
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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