| NPI | 1487897831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAIN JACOBSON President 916-772-4353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 56390) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2009-04-15 |