| NPI | 1518755354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN G PAK Owner 916-903-4082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 292200000X Dental Laboratory |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2025-04-30 |