| NPI | 1285006593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDY HANS Manager 408-842-0418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59700) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55003) |
| 1223G0001X Dentist, General Practice (Licence: CA 60718) | |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |