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NPI Profile for SOUTHWEST OROFACIAL GROUP INC in MESA, AZ.
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Dentist |
122300000X | |||
Orofacial Pain |
1223X2210X |
| NPI Number | 1619707049 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/01/2024 | |
| Last updated | 03/04/2026 - About 3 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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SOUTHWEST OROFACIAL GROUP, INC.