Organization
SA-OMS SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN RATHBURN DDS (MANAGER)
(903) 908-0977
Entity
Organization
Contact information
Practice address
3015 GREEN MEADOW DR, SAN ANGELO, TX 76904-6975
(325) 949-1288
Mailing address
3015 GREEN MEADOW DR, SAN ANGELO, TX 76904-6975
(903) 908-0977
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
06/19/2023
Last updated
07/10/2023
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