| NPI | 1548668544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHUC PHAN TRINH CEO 408-678-0102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 46703) |
| 122300000X Dentist | |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2022-01-26 |