NPI | 1316451784 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY BUTTERY Operations Support Manager 805-456-1235 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2017-11-21 |
Last Update Date | 2021-01-04 |