| NPI | 1093414609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOLA NIETO Office Manager 510-713-6790 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X2210X Dentist Orofacial Pain |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-03-02 |