| NPI | 1932248085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEE Owner Surgeon 714-734-9363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA G73560) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 00008) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2013-08-22 |