| NPI | 1144360769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KLAUS JOHANN RADTKE Dentist 415-225-6675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 45761) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |