Organization
LEANDER ORAL SURGERY AND DENTAL IMPLANTS
Active
Other names
Georgetown Center of Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARION UGOCHUKWU HARRIS DDS, MD (OWNER)
(512) 777-0009
Entity
Organization
Contact information
Practice address
2021 KAUFFMAN LOOP STE 130, GEORGETOWN, TX 78628
(512) 777-0009
(512) 777-5009
Mailing address
2021 KAUFFMAN LOOP STE 130, GEORGETOWN, TX 78628
(512) 777-0009
(512) 777-5009
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36909
TEXAS DENTAL LICENSE
TX
01
—
T1093
TEXAS MEDICAL LICENSE
TX
Enumeration date
06/09/2025
Last updated
06/09/2025
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