NPI | 1457131914 |
---|---|
Other Name | AMOS - TELSTAR |
Entity Type | Organization |
Authorized Contact | NICK SUNDIAM Credentialing Manager 719-300-5933 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2023-10-03 |
Last Update Date | 2024-04-09 |