| NPI | 1912112194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS A CUEVA President 520-298-9186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AZ 4543) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2017-02-24 |