| NPI | 1417459397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ALBERT KORN President 916-447-5676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 38438) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2020-10-27 |