NPI | 1891291712 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLY SUNSHINE Credentialing Specialist 314-413-2803 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2018-03-30 |
Last Update Date | 2024-06-14 |