| NPI | 1346423316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN WESLEY WALTERS Owner/Orthodontist 916-575-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 17796) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |