| NPI | 1215129408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAID SHAARI Owner 916-789-4568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 39080) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2009-05-15 |