is a Oral & Maxillofacial Surgery in , . practices all healthcare services and medical treatments related to Oral & Maxillofacial Surgery. The NPI Number for is 1407808868. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1407808868 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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Provider's Primary Taxonomy Detail
| Speciality | Oral & Maxillofacial Surgery |
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| Taxonomy | 204E00000X |
| Licence No | D5778 |
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Definition: Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 51542573 | AL | BCBS | |
| 9910988 | AL | -- | |
| 9910983 | AL | -- | |
| 9910984 | AL | -- | |
| 9910986 | AL | -- | |
| 51542572 | AL | BCBS | |
| 51542567 | AL | BCBS | |
| 51542574 | AL | BCBS |
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