NPI | 1205005436 |
---|---|
Doing Business As | CIVIC CENTER DENTAL |
Entity Type | Organization |
Authorized Contact | MITCHELL TANCIO Dentist/Owner 510-793-5033 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 40889) |
Enumeration Date | 2008-02-21 |
Last Update Date | 2008-02-21 |