| NPI | 1295062503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KENNETH RALLI Owner 916-773-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 47783) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 47828) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2009-11-06 |