| NPI | 1033488655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEJANDRO RAMOS Manager 664-638-4189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: 1324356) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2011-12-28 |