# ORAGEN LAWTON ORAL SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lawton Oral Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912780560
- **Authorized official:** WHITNEY PAVICK (SR. OPERATIONS MANAGER)
- **Authorized official phone:** (801) 857-7947

## Contact information

- **Practice address:** 3617 W GORE BLVD, LAWTON, OK 73505-6373
- **Practice address phone:** (405) 691-0155
- **Mailing address:** 3617 W GORE BLVD, LAWTON, OK 73505-6373

## 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:** 08/17/2023
- **Last updated:** 08/17/2023