| NPI | 1295496495 | 
|---|---|
| Doing Business As | FAYETTEVILLE FAMILY DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | JING MESTER Treasurer 916-633-1306 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2022-01-10 | 
| Last Update Date | 2022-01-10 |