| NPI | 1194381640 |
|---|---|
| Doing Business As | ORAL & MAXILLOFACIAL SURGERY OF CARBONDALE, INC |
| Entity Type | Organization |
| Authorized Contact | BILLY B LAUN Owner/Provider 618-529-2571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-09-11 |