| NPI | 1164767125 |
|---|---|
| Doing Business As | IMAGE ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | LEANI N. MARTINEZ Ins. Coordinator 916-783-5239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 45886) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: 33473) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: 37283) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 33473) | |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2013-12-20 |