| NPI | 1578807038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH A CALLENDER Managing Orthodontist 209-477-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 35230) |
| Additional Taxonomies | 122300000X Dentist (Licence: 35230) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 35230) | |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: CA 35230) | |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2012-11-21 |