| NPI | 1467727602 |
|---|---|
| Doing Business As | ANACAPA ORAL SURGERY DENTAL IMPLANT DOCTOR |
| Entity Type | Organization |
| Authorized Contact | MARWOOD M STOUT President 805-981-8144 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 36787) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2012-03-21 |