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General NPI Number Information
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NPI Number | 1992375026
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Entity Type | Organization
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Legal Business Name | PALO ALTO ORAL & MAXILLOFACIAL SURGERY
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 853 MIDDLEFIELD RD STE 4
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City | PALO ALTO
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State | CA
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Zip | 94301-2919
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Country | US
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Telephone | 650-617-1900
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Fax | 650-617-1907
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Provider Business Mailing Address
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Address Line | 853 MIDDLEFIELD RD STE 4
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City | PALO ALTO
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State | CA
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Zip | 94301-2919
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Country | US
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Telephone | 650-617-1900
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Fax | 650-617-1907
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Authorized Official
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Title or Position | PROVIDER
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Name | ALEXANDER HOGHOOGHI
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Credential | MD, DDS
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Telephone | 650-617-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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