| NPI | 1093840696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANO WENDELL GUERRA Dentist 916-787-0631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47082) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |