| NPI | 1396497319 |
|---|---|
| Former Legal Business Name | KIMIKO MEDICAL AESTHETICS |
| Doing Business As | GREEN COUNTRY SURGICAL ARTS |
| Entity Type | Organization |
| Authorized Contact | BREANN H TEDESCO Office Manager 918-600-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2025-01-14 |