| NPI | 1063541597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAX FREDERICK MARTIN Partner 209-951-4251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 50953) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |