| NPI | 1548434939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALEN M FILLLMORE Owner 530-894-5185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2024-03-12 |