NPI | 1003016494 |
---|---|
Doing Business As | SOUTHERN CALIFORNIA CENTER FOR ORAL & FACIAL SURGERY |
Entity Type | Organization |
Authorized Contact | JAY B REZNICK Owner 818-996-1200 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA A055148) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA A055148) |
Enumeration Date | 2007-07-23 |
Last Update Date | 2007-12-11 |