| NPI | 1528807112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA DELWICHE President 415-307-0493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-05-22 |