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 |