| NPI | 1093229114 |
|---|---|
| Former Legal Business Name | JAIRO SEPULVEDA DDS, INC. |
| Entity Type | Organization |
| Authorized Contact | JAIRO GIOVANNI SEPULVEDA Dentist/ Owner 559-562-5969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 49802) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |