| NPI | 1093808594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH R. GRONBACH President 925-283-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 44317) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-07-22 |