National Provider Identifier Database

RIVER CITY ORAL AND MAXILLOFACIAL SURGERY PLLC
Oral and Maxillofacial Surgery

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.


Contact Information

RIVER CITY ORAL AND MAXILLOFACIAL SURGERY, PLLC
5418 N LOOP 1604 E
SUITE 101
SAN ANTONIO, TX78023
Phone: 210-778-0002
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for RIVER CITY ORAL AND MAXILLOFACIAL SURGERY, PLLC

NPI Number 1063987626
Legal business name
LBN
RIVER CITY ORAL AND MAXILLOFACIAL SURGERY, PLLC
Authorized official MARK HAVERKORN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/10/2018
Last updated 10/10/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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