| NPI | 1265606487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE SAMUSENKO Office Manager 916-351-9808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41689) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |