| NPI | 1023322468 |
|---|---|
| Doing Business As | PARK BLVD ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | STJEPAN STEVEN PODSTRELENY Owner 619-795-0154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 50861) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2019-07-16 |