| NPI | 1013092584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J MCDONALD Owner 510-724-5064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 35644) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |