| NPI | 1558080838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE WALKER President 408-412-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2022-08-29 |