| NPI | 1649717075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WAYNE MOWER General Manager 661-255-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA 45296) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |