NPI | 1164914982 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELIKA ROE Credentialing 888-247-1869 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
Enumeration Date | 2018-06-06 |
Last Update Date | 2018-06-06 |