Organization
CAPITAL ORAL AND MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC RYAN SMITH DDS (OWNER)
(512) 989-7855
Entity
Organization
Contact information
Practice address
15901 CENTRAL COMMERCE DR STE 601, PFLUGERVILLE, TX 78660-2047
(512) 989-7855
(512) 989-7859
Mailing address
15901 CENTRAL COMMERCE DR STE 601, PFLUGERVILLE, TX 78660-2047
(512) 989-7855
(512) 989-7859
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19812
TX
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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