| NPI | 1164696803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD L. VINES President 408-842-3436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 26556) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |