| NPI | 1215537444 |
|---|---|
| Doing Business As | RIVERSIDE ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | ANDREK JEFFREY INGERSOLL Manager 919-656-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |