| NPI | 1104253178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LAWRENCE DAVIS Pres/Owner/Dentist 805-328-0459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60661) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |