Provider Demographics
NPI:1225051683
Name:CENTER FOR FACIAL &ORAL SURGERY P.A.
Entity Type:Organization
Organization Name:CENTER FOR FACIAL &ORAL SURGERY P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:972-395-7630
Mailing Address - Street 1:3740 N JOSEY LN STE 145
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2477
Mailing Address - Country:US
Mailing Address - Phone:972-395-7630
Mailing Address - Fax:972-395-7625
Practice Address - Street 1:3740 N JOSEY LN STE 145
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2477
Practice Address - Country:US
Practice Address - Phone:972-395-7630
Practice Address - Fax:972-395-7625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F91037Medicare UPIN