NPI | 1255857942 |
---|---|
Entity Type | Organization |
Authorized Contact | EMILY MARIE VACCAREZZA Owner 209-815-5244 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 101468) |
Enumeration Date | 2017-08-15 |
Last Update Date | 2017-08-15 |