| NPI | 1235847088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN TUINEI Credentialing Assistant 888-808-4513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2022-11-10 |