| NPI | 1245829027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PATTERSON Office Manager 013-275-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2021-01-18 |