| NPI | 1063685303 |
|---|---|
| Doing Business As | BROOKSIDE ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | NICOLAS S VEACO President 209-951-9045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA C2845379) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2009-03-20 |