| NPI | 1134399892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICUCCIO A NEGOM Owner, Director, Officer 805-215-3349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 55065) |
| Enumeration Date | 2008-03-09 |
| Last Update Date | 2021-03-12 |