| NPI | 1629785548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF PAZ Owner 210-504-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |