NPI | 1053609842 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY S DEAN President 909-327-8818 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA 59436) |
Enumeration Date | 2011-07-14 |
Last Update Date | 2011-07-14 |