Provider Demographics
NPI:1841093242
Name:FREDERICKSBURG ORAL SURGERY PLLC
Entity type:Organization
Organization Name:FREDERICKSBURG ORAL SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LESSIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:830-217-2930
Mailing Address - Street 1:514 FRIENDSHIP LANE STE C
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4580
Mailing Address - Country:US
Mailing Address - Phone:830-217-2930
Mailing Address - Fax:830-217-2934
Practice Address - Street 1:514 FRIENDSHIP LANE STE C
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4580
Practice Address - Country:US
Practice Address - Phone:830-217-2930
Practice Address - Fax:830-217-2934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty