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General NPI Number Information
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NPI Number | 1891593273
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Entity Type | Organization
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Legal Business Name | ORASURG
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 9560 LEGACY DR STE 220
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City | FRISCO
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State | TX
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Zip | 75033-6759
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Country | US
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Telephone | 469-598-1115
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Fax | 469-598-1119
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Provider Business Mailing Address
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Address Line | 9560 LEGACY DR STE 220
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City | FRISCO
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State | TX
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Zip | 75033-6759
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Country | US
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Telephone | 469-598-1115
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Fax | 469-598-1119
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Authorized Official
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Title or Position | OWNER
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Name | DR. VASIM MOMIN
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Credential | DDS, MD
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Telephone | 404-514-8120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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