NPI | 1548713084 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTIN HAMILTON Aegd Program Director 707-423-7008 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019030225) |
Enumeration Date | 2016-08-02 |
Last Update Date | 2016-08-02 |