Provider Demographics
NPI:1346406675
Name:STONEBRIAR FACIAL & ORAL SURGERY
Entity Type:Organization
Organization Name:STONEBRIAR FACIAL & ORAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-618-3070
Mailing Address - Street 1:5575 WARREN PKWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4062
Mailing Address - Country:US
Mailing Address - Phone:214-618-3070
Mailing Address - Fax:214-618-3071
Practice Address - Street 1:5575 WARREN PKWY
Practice Address - Street 2:SUITE 206
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4062
Practice Address - Country:US
Practice Address - Phone:214-618-3070
Practice Address - Fax:214-618-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty