| NPI | 1093395436 |
|---|---|
| Doing Business As | SHASTA PERIODONTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | JAMIE CASTRO Business Mgr 530-898-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2021-04-09 |