| NPI | 1750169595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY MORA Oral And Maxillofacial Pathologist 919-523-7076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0106X Dentist Oral and Maxillofacial Pathology | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 207ZC0500X Pathology Cytopathology | |
| 207ZI0100X Pathology Immunopathology | |
| 207ZP0007X Pathology Molecular Genetic Pathology | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology | |
| 207ZP0213X Pathology Pediatric Pathology | |
| 208600000X Surgery | |
| 2086X0206X Surgery Surgical Oncology | |
| 261QA1903X Clinic/Center Ambulatory Surgical | |
| 261QD0000X Clinic/Center Dental | |
| 261QM2500X Clinic/Center Medical Specialty | |
| 261QS0112X Clinic/Center Oral and Maxillofacial Surgery | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-09-21 |