| NPI | 1043343130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH F FREER President 707-643-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 3144) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |