Organization
CENTER FOR FACIAL ORAL & IMPLANT SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY P HATZIS DDS, MD (OWNER)
(903) 315-3813
Entity
Organization
Contact information
Practice address
705 E MARSHALL AVE, 4003, LONGVIEW, TX 75601-5573
(903) 315-3810
(903) 315-1937
Mailing address
705 E MARSHALL AVE, 4003, LONGVIEW, TX 75601
(903) 315-3810
(903) 315-1937
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
12/02/2010
Last updated
05/18/2011
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