| NPI | 1821405416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMSEY MATTHEW FANONS Managing Member 806-794-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX TX16343) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 11953) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |