| NPI | 1306199260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN IDE Dentist 559-625-2744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44678) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 54890) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2012-10-16 |