| NPI | 1104371368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE REBECCA EKINS President 800-280-1608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: CA 633) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-08-17 |