| NPI | 1154597920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE DURHAM Office Manager 916-965-8026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 30675) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |