Wichita Falls Oral and Facial Surgery, Pllc
NPI #1255710752 in Wichita Falls, Texas
Provider Information
- NPI Number
- 1255710752
- Entity Type
- Organization
- Organization Name
- Wichita Falls Oral and Facial Surgery, Pllc
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- May 29, 2015
- Last Updated
- May 29, 2015
Practice Location
- Address
- 2304 MIDWESTERN PKWY
- Address 2
- SUITE 102
- City
- Wichita Falls
- State
- Texas
- ZIP Code
- 76308-2342
- Phone
- (940) 696-1544
Authorized Official
- Name
- MR. CLARK ALLEN PETERSEN JR.
- Title
- OPERATIONS DIRECTOR
- Phone
- (618) 402-6622
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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