Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI # | 1689448656 |
| LBN Legal business name | ORAL SURGERY SOUTH-QUALITAS, PC |
| Authorized official | SUZIE FIGUEIREDO - (VP OF HR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/10/2023 |
| Last updated | 05/31/2024 - About 2 years ago |
| Identifiers | n/a |
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