| NPI | 1104156744 |
|---|---|
| Doing Business As | DENTAL SOURCE OF CALIFORNIA |
| Entity Type | Organization |
| Authorized Contact | DONALD CLARKE Corporation President 916-487-0117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2010-01-04 |