Olympic Plaza Oral & Maxillofacial Surgery Assoc.
LBN: Oral & Maxillofacial Surgery Of Tyler, Pc
Olympic Plaza Oral & Maxillofacial Surgery Assoc. is an health care organization with primary practice located at 700 Olympic Plaza Cir Ste 412 , Tyler TX 75701-1952. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty.
Oral & Maxillofacial Surgery Of Tyler, Pc can be contacted via phone (903) 595-5186, or through Grace, Jerri G. via phone (903) 595-5186.
Contact Information
Primary practice address
700 Olympic Plaza Cir Ste 412
Tyler TX 75701-1952
Phone: (903) 595-5186
Fax: (903) 595-5240
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 10456 & 17107 | Texas |
Profile Details
| NPI number | 1154493922 |
|---|---|
| LBN Legal business name | Oral & Maxillofacial Surgery Of Tyler, Pc |
| DBA Doing business as | Olympic Plaza Oral & Maxillofacial Surgery Assoc. |
| Authorized official | Grace, Jerri G. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Jul 16th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154493922 | NPPES |
| Texas | MEDICAID | 080858601 |
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