| NPI | 1144370214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY GONZAGA ISON Dentist 408-272-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 34120) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2012-05-04 |