| NPI | 1063569929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARIE GRADY Owner 559-435-7993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA 53741) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-11-29 |