| NPI | 1104413822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRADFORD JOE President 408-738-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2020-12-29 |