| NPI | 1053974196 |
|---|---|
| Doing Business As | MODESTO ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | BRIAN K HUTTO President 209-522-5238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2024-02-04 |