| NPI | 1134647209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE MCCULLOUGH ESTES President 925-286-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA DDS62336) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2017-09-08 |