Provider Demographics
NPI:1275777872
Name:ASSOCIATED ORAL SURGEONS, PA
Entity Type:Organization
Organization Name:ASSOCIATED ORAL SURGEONS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:P
Authorized Official - Last Name:ONEACRE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-539-1491
Mailing Address - Street 1:3700 FORUMS DRIVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028
Mailing Address - Country:US
Mailing Address - Phone:972-539-1491
Mailing Address - Fax:972-539-3489
Practice Address - Street 1:3700 FORUMS DR
Practice Address - Street 2:SUITE 203
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1860
Practice Address - Country:US
Practice Address - Phone:972-539-1491
Practice Address - Fax:972-539-3489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108301223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty