Provider Demographics
NPI:1144758954
Name:TELFAIR ORAL AND MAXILLOFACIAL SURGERY PLLC
Entity Type:Organization
Organization Name:TELFAIR ORAL AND MAXILLOFACIAL SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYOKO
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-766-7720
Mailing Address - Street 1:13440 UNIVERSITY BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4798
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13440 UNIVERSITY BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4798
Practice Address - Country:US
Practice Address - Phone:281-766-7720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery