| NPI | 1104134899 |
|---|---|
| Doing Business As | SURFSIDE IMPLANT & ORAL SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | KRISTIN E HUDSON Consultant 910-793-9545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 8366) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8366) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-16 |