| NPI | 1376965418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE BURCKHARDT Office Manager 530-877-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 38539) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 60438) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2016-09-02 |