| NPI | 1568676310 |
|---|---|
| Other Name | ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | JOHN TEUNIS KEAVENY Owner 701-225-5163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ND 1444) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-10-04 |