| NPI | 1023609062 |
|---|---|
| Doing Business As | GRAND CANYON ORAL AND FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | SUDHEER SURPURE President 615-480-5534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2021-04-08 |