| NPI | 1386142123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY JAMES ABBOTT Dentist/Owner 805-559-0579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain |
| Additional Taxonomies | 122300000X Dentist |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2024-01-23 |