Advanced Facial Plastic Surgery Center
Specialist in Dallas, TX. Organization (NPI-2).
NPI number1487832010
StatusActive
Last updated in NPPESFeb 6, 2008
Details
- NPI
- 1487832010
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Facial Plastic Surgery Center
- Organization subpart
- No
- Enumeration date
- Feb 6, 2008
- Last updated
- Feb 6, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | K2643 | TX | Yes |
Other names
- Advanced (Other Name)
Practice location
14755 Preston RdSuite 110
Dallas, TX 75254-6815
Phone 972-774-1777 · Fax 972-774-0066
Mailing address
14755 Preston RoadSuite 110
Dallas, TX 75254
Phone 972-774-1777 · Fax 972-774-0066
Authorized official
Benjamin Amos Bassichis
Owner
9727741777
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