| NPI | 1396750097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY R PRESLEY-NELSON Business Manager 415-271-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DC30807) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |