| NPI | 1386107118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO A GOY Billing COO Rdinator 603-595-8889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-04-09 |