Organization
CAPROCK ORAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMSEY MATTHEW FANOUS D.D.S. (OWNER)
(806) 794-0001
Entity
Organization
Contact information
Practice address
5730 66TH ST, LUBBOCK, TX 79424-1224
(806) 794-0001
(806) 794-0025
Mailing address
5730 66TH ST, LUBBOCK, TX 79424-1224
(806) 794-0001
(806) 794-0025
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
TX16343
TX
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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