| NPI | 1578885471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN COLLINS Owner 209-367-3595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 36740) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |