| NPI | 1073862918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK J JELMINI Owner 559-439-2147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 29811) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 61309) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |