| NPI | 1073173860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MICHAEL WOO Gen Partner 559-459-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2024-05-28 |