Organization
UNIVERSITY ORAL & MAXILLO FACIAL SURGEONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MULLASSERIL D.D.S. M.S. (DIRECTOR OF MAXILLOFACIAL PROS)
(405) 271-5744
Entity
Organization
Contact information
Practice address
1201 N STONEWALL AVE, RM 418A, OKLAHOMA CITY, OK 73117-1214
(405) 271-5744
(405) 271-4181
Mailing address
PO BOX 26901, DCS209, OKLAHOMA CITY, OK 73190-0001
(405) 271-5744
(405) 271-4181
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5360
OK
Other
Enumeration date
05/01/2007
Last updated
08/29/2008
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