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Organization

CAPROCK ORAL SURGERY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAMSEY MATTHEW FANONS DDS (MANAGING MEMBER)
(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
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
11953
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
TX16343
TX

Other

Enumeration date
07/16/2014
Last updated
07/16/2014
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