Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI # | 1073295382 |
| LBN Legal business name | FAMILIES FIRST ORAL SURGERY |
| Authorized official | ALISHA SHIGLEY - (RMC MANAGER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/04/2023 |
| Last updated | 09/08/2023 - About 3 years ago |
| Identifiers | n/a |
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