| NPI | 1063690436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB DAVID KOENITZER Owner 707-766-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 34624) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2008-02-07 |