| NPI | 1407073778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARMELL RAFISOLYMAN Owner 559-256-2150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 47997) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |