| NPI | 1447688551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RODNEY TELLES President / Omfs 714-766-6560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 55094) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2021-06-17 |