| NPI | 1124291711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DO President 209-826-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 45452) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 52062) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2008-04-04 |