| NPI | 1154946622 |
|---|---|
| Doing Business As | INNOVATIVE PERIODONTICS AND DENTAL IMPLANTS |
| Entity Type | Organization |
| Authorized Contact | KATHRYN UEMURA CFO 707-479-7981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |