| NPI | 1053860627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLORA TRANG PELACHYK Vice President 209-914-5506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901021804) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |