| NPI | 1306019245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA MENDOZA Manager 209-394-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 31813) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2015-10-08 |