| NPI | 1336785690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY K WALKER Owner 805-794-5867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2020-01-23 |