Provider Demographics
NPI:1346046406
Name:ALIGN ORAL SURGERY
Entity type:Organization
Organization Name:ALIGN ORAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEOPLE EXPERIENCE LEADER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAMIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-944-0504
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-0010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12014 HUEBNER RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1296
Practice Address - Country:US
Practice Address - Phone:210-944-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty