| NPI | 1326468752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA BRUNO Administrator 209-527-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 32447) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2016-07-01 |