| NPI | 1265029250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIQUINTA PIPES Office Manager 870-550-4934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-12-24 |
| Last Update Date | 2020-12-24 |