Organization
ORAL AND MAXILLOFACIAL SURGEONS OF NORTHEAST TEXAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRBY LEON BUNEL JR. D.D.S. (PRESIDENT)
(903) 794-3331
Entity
Organization
Contact information
Practice address
1701 MOORES LN, TEXARKANA, TX 75503-1894
(903) 794-3331
(903) 793-7217
Mailing address
1701 MOORES LN, TEXARKANA, TX 75503-1894
(903) 794-3331
(903) 793-7217
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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