| NPI | 1497199830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA D PENA President 209-830-7477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47774) |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2013-04-27 |