| NPI | 1093210353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LYNN NITTA Office Manager 559-259-5650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 49913) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |