Organization
TYLER ORAL & FACIAL SURGERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAKOTO SAIGUSA DMD, MD (V-PRES.)
(903) 592-1664
Entity
Organization
Contact information
Practice address
805 TURTLE CREEK DR, TYLER, TX 75701-1937
(903) 592-1664
(903) 525-1099
Mailing address
805 TURTLE CREEK DR, TYLER, TX 75701-1937
(903) 592-1664
(903) 525-1099
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195647603-01
—
TX
Enumeration date
08/17/2007
Last updated
01/23/2023
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