| NPI | 1225274442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL PETERSEN President 530-223-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 57031) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2008-12-17 |