| NPI | 1538725312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE BURUCA Assistant Manager 559-222-2522 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |