| NPI | 1326678087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP LAWRENCE CHING Specialty/Insurance Director 408-607-3276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |