Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI Number | 1659047017 |
| LBN Legal business name | ORAGEN, LLC |
| Authorized official | QUADE REYNOLDS - (DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/17/2021 |
| Last updated | 08/17/2021 - About 5 years ago |
| Identifiers | n/a |
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