| NPI | 1215048319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW GREGORY MILLER Owner 831-375-4877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 45591) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-10-27 |