Organization
ORAL SURGERY OFFICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD E GOWANS DDS (OWNER PRESIDENT)
(916) 782-2161
Entity
Organization
Contact information
Practice address
730 SUNRISE AVE, STE 130, ROSEVILLE, CA 95661
(916) 782-2161
(916) 782-0677
Mailing address
730 SUNRISE AVE, STE 130, ROSEVILLE, CA 95661
(916) 782-2161
(916) 782-0677
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043408925
DR GOWANS
—
Enumeration date
01/18/2008
Last updated
01/18/2008
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