NPI | 1831863737 |
---|---|
Entity Type | Organization |
Authorized Contact | PHI LE Credentialing Contracts Manager 267-575-2321 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
Enumeration Date | 2021-08-04 |
Last Update Date | 2021-08-04 |