| Name | Value |
|---|---|
| PROVIDER TYPE | Ambulatory Health Care Facilities |
| CLASSIFICATION | Clinic/Center |
| DEFINITION | The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| AREA OF SPECIALIZATION | Oral and Maxillofacial Surgery |
| STATUS | Active |
| X12 CODE | 261QS0112X |
| INDIVIDUAL/NON | NON-INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252267 |
| EFFECTIVE DATE/TIME |
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