| NPI | 1548086820 |
|---|---|
| Doing Business As | MACT DENTAL, SONORA |
| Entity Type | Organization |
| Authorized Contact | JOHN SHAWVER ALEXANDER Executive Director 209-754-6262 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |