| NPI | 1154512747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER THOMPSON Manager 916-391-0682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 18162) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |