| NPI | 1861502072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN M BABBITT Insurance Biller 909-982-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 42654) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-08-13 |