| NPI | 1124328422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE C SABLAN Owner Dentist 510-252-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 44075) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 46602) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2010-11-02 |