| NPI | 1215149166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALLEN SCHLIE CEO 530-244-6054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 27366) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 5995) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |