| NPI | 1255685061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLEN PHILLIPS Executive Officer 559-732-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 28844) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |