NPI | 1700159548 |
---|---|
Entity Type | Organization |
Authorized Contact | BRUCE B CHISHOLM President 760-779-9559 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA G81937) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G81937) |
Enumeration Date | 2012-02-09 |
Last Update Date | 2012-02-09 |