Provider Demographics
NPI:1720970478
Name:VISUAL SURGICAL ARTS, SC
Entity type:Organization
Organization Name:VISUAL SURGICAL ARTS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LACY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-251-3985
Mailing Address - Street 1:20 BRONZE POINTE N
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-1099
Mailing Address - Country:US
Mailing Address - Phone:618-787-6725
Mailing Address - Fax:618-403-6726
Practice Address - Street 1:20 BRONZE POINTE N
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1099
Practice Address - Country:US
Practice Address - Phone:618-787-6725
Practice Address - Fax:618-403-6726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty