| NPI | 1124573753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY EMMERSON Practice Administrator 530-823-2568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38428) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2018-08-29 |