| NPI | 1801685888 |
|---|---|
| Former Legal Business Name | ORTA ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | JACKIE HOLLOWAY Director Revenue Cycle Management 854-200-7970 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-05 |