Organization
HIGHLAND PARK MSO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN GRAHAM (CHIEF OPERATING OFFICER)
(310) 739-5685
Entity
Organization
Contact information
Practice address
3001 KNOX ST STE 301, DALLAS, TX 75205-5593
(214) 824-8960
Mailing address
550 RESERVE ST STE 330, SOUTHLAKE, TX 76092-1599
(817) 226-6790
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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