| NPI | 1265898357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENA ORTIZ Credentialling Specialist 408-918-2618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 63902) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |