| NPI | 1184401622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAREQ IZZAT BECK President 346-289-5765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-08 |