| NPI | 1962028142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN ALEXANDER PHAM Owner 210-538-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |