| NPI | 1619021862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE THOMAS GOFFAS Surgeon 810-733-5570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 204E00000X Oral & Maxillofacial Surgery | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2008-03-26 |