| NPI | 1073979472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBENCILLO HERRERA SANTOS President 209-537-5783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59933) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2016-01-14 |