| NPI | 1235551342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN WALLS Deputy Executive Director 209-577-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56244) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |