| NPI | 1679902407 |
|---|---|
| Other Name | GENESIS ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | ANTOINE GERARD JOHNSON Oral Surgeon 410-465-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MD 14853) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2021-09-29 |