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ROSWELL ORAL & FACIAL SURGERY LLC NPI 1518351790


NPI Information

NPI: 1518351790
Provider Name: ROSWELL ORAL & FACIAL SURGERY, LLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 32D0537391

Address:
207 N UNION AVE
STE E
ROSWELL, NM
ZIP 88201
Phone: (575) 623-5711
Get Directions

ROSWELL ORAL & FACIAL SURGERY, LLC is an oral and maxillofacial surgery dentist in Roswell, NM. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. ROSWELL ORAL & FACIAL SURGERY, LLC NPI is 1518351790. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

207 N UNION AVE
STE E
ROSWELL, NM
ZIP 88201-068
Phone: (575) 623-5711
Fax: (575) 622-8922

The provider's authorized official is Bryce Heiner .
The authorized official title is Owner/surgeon and has the following contact phone number (575) 522-8800.

The CLIA number assigned to this NPI record is 32D0537391 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/25/2015 and was last updated on 3/25/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryDD3068NEW MEXICOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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