| NPI | 1396963633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY RICHARD RODIG Owner President 209-524-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 31851) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |