| NPI | 1215301957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN NANCY LEIGHTY Special Administrator 530-886-8871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 40370) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2015-11-18 |