| NPI | 1255759650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN J. ULLOA Oral&Maxillofacial Surgeon/Owner 701-721-5254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ND 1993) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |