| NPI | 1144766528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI BALDERSTON Bookkeeper 530-872-2489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 42119) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |