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 |