Aesthetic Oral & Facial Surgical Center of the Southwest, PC
Organization Active NPI Oral and Maxillofacial Surgery Clinic/Center · Keller, TX
NPI 1790778314 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1790778314
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/Center 261QS0112X
- License
- 17519 (TX)
- Legal business name
- AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC
- Practice address
- 1850 Keller Pkwy
Suite 102
Keller, TX 76248-3706 - Phone
- (817) 431-9566
- Fax
- (817) 337-8687
- NPI assigned
- Aug 30, 2005
- Organization subpart
- No
Authorized official
- Name
- William J Starck, DDS
- Title
- President
- Phone
- (817) 431-9566
Practitioners 1
-
Mazen Duraini, MD, DDS
National Provider Directory
Locations
1850 Keller Pkwy
Ste 102
Keller, TX 76248
Phone (817) 431-9566
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery Clinic/Center | 261QS0112X | 17519 | TX | Yes |
Addresses
Primary practice location
1850 Keller Pkwy
Suite 102
Keller, TX 76248-3706
Mailing address
1850 Keller Pkwy
Suite 102
Keller, TX 76248-3706
Phone (817) 431-9566
Other providers in Keller, TX
- Adjoining Hands HCS, Inc.
- Advanced Endodontics of DFW
- Advanced Neuromuscular Performance & Physical Therapy LLC
- Advanced Spine Solutions PA
- Aegis Group Practice LLC
- Gertrude Agyekum
- Aileen Wainwright, LCSW Inc.
- Airy Choi DMD, PLLC
- Amy Akabue-Isom
- Christopher Lucas Alamilla
All providers in Keller, TX · Oral and Maxillofacial Surgery Clinic/Center 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.