| NPI | 1205608916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS TEIXEIRA Owner 209-632-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2024-11-04 |