| NPI | 1114355575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLAS PHILIPPE BEBEAU Owner 480-300-7152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AZ 47593) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2013-10-23 |