| NPI | 1508124074 |
|---|---|
| Former Legal Business Name | GOTTA SMILE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CARLOS JACOBO Manager 209-952-3687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38433) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 60929) |
| 122300000X Dentist (Licence: CA 61240) | |
| 122300000X Dentist (Licence: CA 100679) | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2016-09-20 |