| NPI | 1366299091 |
|---|---|
| Doing Business As | VISTA ORAL SURGERY AND IMPLANTS - RALEIGH |
| Entity Type | Organization |
| Authorized Contact | AMENA H Credentialing Specialist 910-941-0564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-05-01 |