| NPI | 1194107748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN CASTILLO Operations Manager 916-781-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 48036) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2023-03-01 |