| NPI | 1013773001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAX MCCUSKER Authorized Official 949-521-2757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-29 |