| NPI | 1205039518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | H CHARLES MCKELVEY Owner 209-532-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 34879) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |