| NPI | 1649599267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS SONG President 415-668-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| 204E00000X Oral & Maxillofacial Surgery | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2017-09-22 |