NPI | 1487860573 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY J PETTIT President 530-662-3915 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 21494) |
Enumeration Date | 2007-05-15 |
Last Update Date | 2020-08-22 |