| NPI | 1003362955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO BUSQUETS Part Owner 510-538-2566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 55857) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-09-02 |