| NPI | 1295261600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDE CRUTCHFIELD Owner 916-435-5230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 58211) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2017-05-04 |