| NPI | 1689430761 |
|---|---|
| Doing Business As | SOUTHLAKE ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | BERT CAMERON WENDLING Owner/Surgeon 214-205-8570 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |