| NPI | 1104430131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE STIEFEL Owner/Doctor 603-257-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |