| NPI | 1508294927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED PEGUEROS Assoc Dean, Budget & Fin Admin, AO 415-351-7192 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2022-12-01 |