| NPI | 1861400756 |
|---|---|
| Doing Business As | FACIAL SURGERY CENTER I |
| Entity Type | Organization |
| Authorized Contact | JEFF GOODE President 304-388-7783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2007-11-15 |