| NPI | 1073265146 |
|---|---|
| Doing Business As | THE LODI DENTIST |
| Entity Type | Organization |
| Authorized Contact | SHANA ACKERMAN Manager 209-369-3657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-20 |