| NPI | 1497547517 |
|---|---|
| Doing Business As | LAKE RIVER ORAL AND FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | JONATHAN DANIEL CHODROFF Oral Surgeon 302-379-3104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2025-05-22 |
| Last Update Date | 2025-05-22 |