| NPI | 1205045432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ASHTON VELLEQUETTE Dentist Provider 408-245-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 29513) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |