Organization
KERRVILLE ORAL & MAXILLOFACIAL SURGERY, P.A.
Active
Organization
KERRVILLE ORAL & MAXILLOFACIAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN GREEN (PRESIDENT)
(903) 526-7366
Entity
Organization
Contact information
Practice address
501 JEFFERSON ST, SUITE 2, KERRVILLE, TX 78028-4561
(830) 895-3494
(830) 896-3390
Mailing address
501 JEFFERSON ST, SUITE 2, KERRVILLE, TX 78028-4561
(830) 895-3494
(830) 896-3390
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
24237
TX
Other
Enumeration date
05/23/2011
Last updated
07/08/2011
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