| NPI | 1356096523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOSHIKO HART Owner 209-543-6937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2023-11-06 |