| NPI | 1447673173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STONE R THAYER President 786-471-4299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: FL ME114524) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME114524) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2015-01-24 |