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General NPI Number Information
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NPI Number | 1720970478
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Entity Type | Organization
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Legal Business Name | VISION SURGICAL ARTS, PC
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 20 BRONZE POINTE N
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City | SWANSEA
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State | IL
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Zip | 62226-1099
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Country | US
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Telephone | 618-787-6725
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Fax | 618-403-6726
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Provider Business Mailing Address
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Address Line | 20 BRONZE POINTE N
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City | SWANSEA
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State | IL
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Zip | 62226-1099
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Country | US
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Telephone | 618-787-6725
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Fax | 618-403-6726
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LACY WILSON
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Credential |
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Telephone | 314-251-3985
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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 |
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License Number State |
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