| NPI | 1245388032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APPANAGARI GNANADEV President 909-580-6210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA 51201) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |