| NPI | 1437923901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY LEBAR Doctor 408-540-4008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |