Organization
DOUGLAS MAXSON
Active
Other names
DOUGLAS R MAXSON DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS MAXSON (OWNER)
(408) 996-0176
Entity
Organization
Contact information
Practice address
1198 S DE ANZA BLVD, SAN JOSE, CA 95129-3632
(408) 996-0176
Mailing address
1198 S DE ANZA BLVD, SAN JOSE, CA 95129-3632
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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