| NPI | 1154525624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADER MOAVENIAN President 603-595-8889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NH 3216) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-07-21 |