| NPI | 1154552685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN JEAN EVERETT Office Manager 209-823-9346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 23538) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2009-07-31 |