| Brookside Oral & Maxillofacial Surgery | |
|
3427 Deer Park Dr Sutie B Stockton CA 95219-2355 | |
| (209) 951-9045 | |
| (209) 951-9047 |
| Full Name | Brookside Oral & Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3427 Deer Park Dr, Stockton, California |
| Authorized Official Name and Position | Nicolas S Veaco (PRESIDENT) |
| Authorized Official Contact | 2099519045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Oral & Maxillofacial Surgery 3427 Deer Park Dr Sutie B Stockton CA 95219-2355 Ph: (209) 951-9045 | Brookside Oral & Maxillofacial Surgery 3427 Deer Park Dr Sutie B Stockton CA 95219-2355 Ph: (209) 951-9045 |
| NPI Number | 1063685303 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 03/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063685303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | C2845379 (California) | Primary |
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