| NPI | 1306034293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS JORDAN WIDMAN President 408-265-4480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 18666) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |