| NPI | 1184892028 |
|---|---|
| Former Legal Business Name | TRAVIS & NOLEN ORAL & MAXILLOFACIAL SURGERY, P.C. |
| Entity Type | Organization |
| Authorized Contact | DAUN M. BRANDT Business Manager 314-726-2755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 12435) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2023-04-11 |