| NPI | 1467628222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK G. WOMACK Owner/President 530-345-7127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA D37037) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |