| NPI | 1568502821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDRIC R WARREN President, Orthodontist 415-681-2418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA D29865) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |