| NPI | 1073721221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORD GIBSON ROBERTS President 925-846-3248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA D19800) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2020-08-22 |