| NPI | 1558713693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN THOMAS CARSON President 916-965-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA CA32042) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-07-12 |