| NPI | 1437396876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN GRAVES Owner 805-557-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 54658) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |