Angelo Oral & Maxillofacial Surgery, P. a.
Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · San Angelo, TX
NPI 1295863207 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1295863207
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 14472 (TX)
- Legal business name
- ANGELO ORAL & MAXILLOFACIAL SURGERY, P. A.
- Practice address
- 3012 Green Meadow Dr
San Angelo, TX 76904-6974 - Phone
- (325) 944-3565
- NPI assigned
- Mar 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Grady W. Bryan, DDS, MD
- Title
- President
- Phone
- (325) 944-3565
Practitioners 1
-
Tony Montgomery, DMD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | 14472 | TX | Yes |
Addresses
Primary practice location
3012 Green Meadow Dr
San Angelo, TX 76904-6974
Mailing address
3012 Green Meadow Dr
San Angelo, TX 76904-6974
Phone (325) 944-3565
Other providers in San Angelo, TX
- Angelo General & Thoracic Surgery
- Angelo Healthcare Services, Inc.
- Angelo Kidney Connection at Home, PLLC
- Angelo Kidney Connection, PLLC
- Angelo Nephrology Associated
- Angelo Pharmacy Corp
- Angelo Pharmacy Corp
- Angelo Physical Therapy and Wellness
- Angelo Sports Performance and Rehab LLC
- Suzen Angle
All providers in San Angelo, TX · Oral and Maxillofacial Surgery (Dentist) in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.