| 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 |