Organization
SETON ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAYTON CARSNER (VP/COO)
(512) 324-5846
Entity
Organization
Contact information
Practice address
901 W 38TH ST, SUITE 410, AUSTIN, TX 78705
(512) 992-1378
(512) 992-1379
Mailing address
1345 PHILOMENA ST, STE 410.3, AUSTIN, TX 78723
(512) 992-1378
(512) 992-1379
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
07/22/2019
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