| NPI | 1033893045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTE LEE FONTAINE Registered Dental Hygienist Ap 650-520-0396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist |
| Additional Taxonomies | 125K00000X Advanced Practice Dental Therapist |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-06-12 |