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General NPI Number Information
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NPI Number | 1629267075
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Entity Type | Organization
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Legal Business Name | ORAL-FACIAL SURGERY CENTER APC
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1608 POLK ST
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City | HOUMA
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State | LA
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Zip | 70360-6011
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Country | US
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Telephone | 985-879-1972
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Fax | 985-879-4661
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Provider Business Mailing Address
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Address Line | 1608 POLK ST
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City | HOUMA
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State | LA
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Zip | 70360-6011
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Country | US
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Telephone | 985-879-1972
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Fax | 985-879-4661
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER J. SAAL
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Credential | DDS, MD
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Telephone | 985-879-1972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | OC-07906
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License Number State | LA
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