| NPI | 1730914433 |
|---|---|
| Doing Business As | TAHOE FACIAL PLASTIC SURGERY |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BRADFORD CEO 808-936-3090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| 208200000X Plastic Surgery | |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-09-04 |