| NPI | 1316492960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WILLIAM HOMPESCH Sole Owner 907-374-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: AK 105542) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |