| NPI | 1114063674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE GRACE GACUSAN ELLORIN Chief Executive Officer Dentist 408-736-7299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 46788) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2012-03-20 |