Provider Demographics
NPI:1073173860
Name:OMFS CARE CENTER PARTNERS
Entity Type:Organization
Organization Name:OMFS CARE CENTER PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GEN PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:559-459-4101
Mailing Address - Street 1:215 N FRESNO ST STE 490
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-0000
Mailing Address - Country:US
Mailing Address - Phone:559-459-4101
Mailing Address - Fax:559-459-5744
Practice Address - Street 1:215 N FRESNO ST STE 490
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-0000
Practice Address - Country:US
Practice Address - Phone:559-459-4101
Practice Address - Fax:559-459-5744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty