| NPI | 1043589096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARROD CORNEHL President 415-392-5025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52365) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2022-01-31 |