| NPI | 1043753189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD ALLEN President 831-757-3021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA 59575) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |