| NPI | 1275924789 |
|---|---|
| Doing Business As | STONELAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | HUNG Q LE CEO 916-691-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |