| NPI | 1255768123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONG XIE Chief Officer 510-637-8289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 58642) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 58642) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| Enumeration Date | 2013-10-08 |
| Last Update Date | 2023-04-14 |