| NPI | 1174942007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A MCCULLA Owner 209-667-7889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 31326) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2014-04-08 |