| NPI | 1396137675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELMA DANIELLE PEARA Receptionist 209-723-0767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 15274) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |