| NPI | 1154251312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MARIE YELLICH Clinical Director 831-883-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2026-05-20 |
| Last Update Date | 2026-05-20 |