| NPI | 1417164104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYMIE SANTIAGO Office Manager 707-645-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43362) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |