| NPI | 1043422199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEROY DAGUE Owner 530-222-0939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 23999) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |