| NPI | 1316188436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTYNE VU Office Manager 925-484-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 47258) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 49207) |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2009-04-28 |