| NPI | 1366537946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN ALAN MIDDLETON Dentist Owner 916-486-2838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38447) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |