| NPI | 1255357893 |
|---|---|
| Doing Business As | PENINSULA ORAL SURGERY & IMPLANTS |
| Entity Type | Organization |
| Authorized Contact | THOMAS T. OMOTO President 310-325-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 31506) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2022-10-27 |