| NPI | 1538181425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH KANEGAWA Dentist 209-369-3114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 29318) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |