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General NPI Number Information
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NPI Number | 1881066751
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Entity Type | Organization
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Legal Business Name | SPRING CYPRESS ORAL SURGERY & IMPLANT CENTER, PLLC
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 12065 SPRING CYPRESS RD
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City | TOMBALL
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State | TX
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Zip | 77377-8040
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Country | US
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Telephone | 281-205-7211
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Fax | 832-843-6150
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Provider Business Mailing Address
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Address Line | 12065 SPRING CYPRESS RD
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City | TOMBALL
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State | TX
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Zip | 77377-8040
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Country | US
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Telephone | 281-205-7211
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Fax | 832-843-6150
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | DR. MICHAEL LUIS FUENTES
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Credential | DDS
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Telephone | 281-205-7211
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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 | TX
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