| NPI | 1427111566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ALAN HOLMAN Corp Officer 650-366-5758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 23516) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |