| NPI | 1033796362 |
|---|---|
| Doing Business As | FUSION IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | CHRISTI WYATT Insurance Manager 225-766-5413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-03-29 |