| NPI | 1740703842 |
|---|---|
| Doing Business As | MID AMERICA ORAL SURGERY AND IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | REZA MOVAHED Owner 618-206-2630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2023-01-24 |