| NPI | 1205922705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA M LIZAOLA Administrative Assistant 831-442-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 37400) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-03-29 |