| NPI | 1104318013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS JOSEPH GALLIA Doctor 916-570-3088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |