| NPI | 1932454030 |
|---|---|
| Doing Business As | CAPITAL ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | RYAN DAVID WOMACK Owner 360-754-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: WA DE.60280647) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2012-07-16 |