| NPI | 1225420979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON CHRISTOPHER ERCOLE Owner Of Business 562-833-5570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery (Licence: RI DEN03249) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-12-30 |