| NPI | 1255502522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY DERHAM President 415-892-4721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38914) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |