| NPI | 1477910602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY LIEU Owner 707-795-4523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 55913) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |