| NPI | 1184816589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES J ROTH President 707-448-5339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA DL 28481) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2007-08-10 |