| NPI | 1356892657 |
|---|---|
| Doing Business As | NEWPORT ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | THOMAS RAYMOND MICHAELIS Partner 949-760-1661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 38855) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 22313) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 42745) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 58948) | |
| 204E00000X Oral & Maxillofacial Surgery | |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2020-01-23 |