| NPI | 1003278995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOSTANTIONS PRIES Owner 408-260-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 53853) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-07-26 |