| NPI | 1477085603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEERTHI GOLLA Dentist 650-369-3695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 100398) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |