| NPI | 1265909113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE E. ROTH President 707-448-6271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2020-11-02 |