NPI | 1427853985 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC WESTERGARD Owner 877-712-7875 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2025-02-18 |
Last Update Date | 2025-05-13 |