| NPI | 1386203016 |
|---|---|
| Doing Business As | LAKE FOREST ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | SUZIN UM Surgeon 949-203-3177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |