NPI | 1447857024 |
---|---|
Doing Business As | GRAND CANYON ORAL AND FACIAL SURGERY |
Entity Type | Organization |
Authorized Contact | SUDHEER J. SURPURE President 615-480-5534 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
Enumeration Date | 2020-10-06 |
Last Update Date | 2020-10-06 |