# STONE ORAL FACIAL SURGERY GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Surgical Arts
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912258740
- **Authorized official:** DR. CHARLES G STONE JR. DDS (OWNER/OFFICER)
- **Authorized official phone:** (903) 534-1414

## Contact information

- **Practice address:** 2550 ELKTON TRL, TYLER, TX 75703-0594
- **Practice address phone:** (903) 534-1414
- **Practice address fax:** (903) 534-1415
- **Mailing address:** 2550 ELKTON TRL, TYLER, TX 75703-0594
- **Mailing address phone:** (903) 534-1414
- **Mailing address fax:** (903) 534-1415

## 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:** 09/19/2012
- **Last updated:** 12/26/2013