| NPI | 1407620859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL HANSEN CEO 916-768-7592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2024-03-15 |