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Organization
SOUTHLAKE CENTER FOR ORAL AND RECONSTRUCTIVE SURGERY, PLLC
Active
Organization
SOUTHLAKE CENTER FOR ORAL AND RECONSTRUCTIVE SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SCHWITZER (MANAGER)
(516) 680-0337
Entity
Organization
Contact information
Practice address
1480 CORPORATE CIR STE 180, SOUTHLAKE, TX 76092-5964
(516) 680-0337
Mailing address
1480 CORPORATE CIR STE 180, SOUTHLAKE, TX 76092-5964
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
Other
Enumeration date
09/29/2026
Last updated
09/29/2026
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