# SOUTHLAKE CENTER FOR ORAL AND RECONSTRUCTIVE SURGERY, PLLC

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

## Provider details

- **NPI number:** 1912811977
- **Authorized official:** DAVID SCHWITZER (MANAGER)
- **Authorized official phone:** (516) 680-0337

## Contact information

- **Practice address:** 1480 CORPORATE CIR STE 180, SOUTHLAKE, TX 76092-5964
- **Practice address phone:** (516) 680-0337
- **Mailing address:** 1480 CORPORATE CIR STE 180, SOUTHLAKE, TX 76092-5964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |

## Other

- **Enumeration date:** 09/29/2026
- **Last updated:** 09/29/2026