NPI | 1518700822 |
---|---|
Doing Business As | JUST FOR GRINS |
Entity Type | Organization |
Authorized Contact | KUSHBOO KUMAR Credentialing Specialist 916-877-7450 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2024-06-14 |
Last Update Date | 2024-06-14 |