NPI | 1073875852 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTY RICHARD LIPSEY President 209-380-5486 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 26675) |
Enumeration Date | 2012-06-08 |
Last Update Date | 2013-01-15 |