| NPI | 1023312105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY ELIZABETH ANDRE Dentist/Chairman Of The Board 925-462-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43697) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 43698) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-01-04 |