| NPI | 1376184390 |
|---|---|
| Doing Business As | LAKE MERRITT DENTAL |
| Entity Type | Organization |
| Authorized Contact | YAO XI Operations Manager 510-701-0654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2019-10-01 |