| NPI | 1285761858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS LEO MULLOOLY President 650-873-6681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 19127) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |