| NPI | 1366039075 |
|---|---|
| Doing Business As | ORAL FACIAL SURGERY INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | LACY WILSON Business Manager 314-251-6725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2024-03-04 |