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SOUHWEST ORAL SURGERY PC NPI 1134596166


NPI Information

NPI: 1134596166
Provider Name: SOUHWEST ORAL SURGERY PC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
3617 W GORE BLVD STE B
LAWTON, OK
ZIP 73505
Phone: (580) 355-6000
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SOUHWEST ORAL SURGERY PC is an oral and maxillofacial surgery dentist in Lawton, OK. 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. SOUHWEST ORAL SURGERY PC NPI is 1134596166. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3617 W GORE BLVD STE B
LAWTON, OK
ZIP 73505-373
Phone: (580) 355-6000
Fax: (580) 355-7060

The provider's authorized official is Stephanie Grigg .
The authorized official title is Business Manager and has the following contact phone number (803) 556-0005.

The enumeration date for this NPI number is 8/25/2015 and was last updated on 10/25/2019.


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 Surgery6721OKLAHOMAYes

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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