| NPI | 1457801789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA UTECHT Office Manager 805-498-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 45073) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: CA 61864) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |