Organization
SONORA ORAL & MAXILLOFACIAL SURGERY DENTAL GROUP
Active
Other names
Sonora Oral & Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SLIM BOUCHOUCHA D.D.S., M.S. (DOCTOR/OWNER)
(209) 532-5578
Entity
Organization
Contact information
Practice address
940 SYLVA LN, SUITE K-1, SONORA, CA 95370-5969
(209) 532-5578
(209) 532-6730
Mailing address
940 SYLVA LN, SUITE K-1, SONORA, CA 95370-5969
(209) 532-5578
(209) 532-6730
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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