| NPI | 1649707514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GORDON MINTO Owner 251-990-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 6381) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2017-05-22 |