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General NPI Number Information
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NPI Number | 1184411829
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Entity Type | Organization
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Legal Business Name | LOCKHART ORAL SURGERY AND DENTAL IMPLANT CENTER, PLLC
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 1418 S COLORADO ST
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City | LOCKHART
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State | TX
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Zip | 78644-3940
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Country | US
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Telephone | 737-732-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 SAD WILLOW PASS
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City | DRIFTWOOD
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State | TX
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Zip | 78619-4488
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Country | US
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Telephone | 818-430-6948
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SALLY MOSER
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Credential | DDS
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Telephone | 818-430-6948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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