| NPI | 1154649671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J. BLACK Owner 916-483-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 40140) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2010-05-07 |