| NPI | 1619579240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ROBERT ROWAN Associate Oral & Max Surgeon 209-383-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2020-11-09 |