| NPI | 1447780887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK W BANKS President 831-637-8133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57965) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2022-07-21 |