| NPI | 1104540673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRADLEY Director Of Operations 559-432-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-10-14 |