| NPI | 1134493943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J TETRICK Certified Dental Technician 916-487-2236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: CA 347527) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-02-27 |