| NPI | 1104979707 |
|---|---|
| Other Name | COASTAL MAXILLOFACIAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MARSHALL SHERIDAN HUMES President 805-928-7611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 27297) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-07-17 |