| NPI | 1104161074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAUGHN ANTHONY LEE President 510-834-4640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 24471) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2012-12-04 |