Organization
AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J STARCK DDS (PRESIDENT)
(817) 431-9566
Entity
Organization
Contact information
Practice address
1850 KELLER PKWY, SUITE 102, KELLER, TX 76248-3706
(817) 431-9566
(817) 337-8687
Mailing address
1850 KELLER PKWY, SUITE 102, KELLER, TX 76248-3706
(817) 431-9566
(817) 337-8687
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
17519
TX
Other
Enumeration date
08/30/2005
Last updated
08/22/2020
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