| NPI | 1447781026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS WILLIAMS Project Manager 925-828-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 41261) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 54869) |
| 122300000X Dentist (Licence: CA 35603) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |