| NPI | 1144431495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MICHAEL WISENER Owner 559-449-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA ds-26246) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |