| NPI | 1457751273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER E KIM President 513-802-2799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery (Licence: WA DE 60468228) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2014-08-28 |