| 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 |