| NPI | 1366468530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SANDERS CROCKETT Dentist 510-581-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 26977) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |