Organization
ORAL AND MAXILLOFACIAL SURGEONS OF NORTHEAST TEXAS, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRBY LEON BUNEL JR. D.D.S. (PRESIDENT)
(903) 794-3331
Entity
Organization
Contact information
Practice address
1701 MOORES LN, TEXARKANA, TX 75503-1894
(903) 794-3331
Mailing address
1701 MOORES LN, TEXARKANA, TX 75503-1894
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
TX
Other
Enumeration date
08/08/2008
Last updated
08/08/2008
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