| NPI | 1255817375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JAMES COOLIDGE Owner 408-736-4344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 55295) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-11 |