NPI | 1265200356 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGIE BURUCA Enrollment Coordinator 559-837-1066 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2023-12-18 |
Last Update Date | 2024-08-05 |