NPI | 1306041363 |
---|---|
Doing Business As | USADC ORAL SURGERY-SAMMC |
Entity Type | Organization |
Authorized Contact | CLENTON BALLARD C, Ubo 210-916-8561 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
Enumeration Date | 2007-06-19 |
Last Update Date | 2019-02-08 |