| NPI | 1043840200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KJELD AAMODT Owner 831-238-7285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-04-17 |