| NPI | 1700178555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON P BURKE Director 210-630-9909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 25153) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2024-01-17 |