Organization
PAYNE SANGHVI ORAL AND MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY C PAYNE DDS, MD (PARTNER)
(209) 951-6387
Entity
Organization
Contact information
Practice address
756 PORTER AVE, SUITE 400, STOCKTON, CA 95207-4232
(209) 951-6387
(209) 951-2824
Mailing address
756 PORTER AVE, SUITE 400, STOCKTON, CA 95207-4232
(209) 951-6387
(209) 951-2824
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
A89128
CA
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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