| NPI | 1326204009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTY R LIPSEY President 209-527-1995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 26675) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2014-06-21 |