| NPI | 1306071758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES RANDY LANDIS President/Owner 530-893-3912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 31940) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2015-11-03 |