| NPI | 1578963559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL GUT LUM President 510-792-3286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 39984) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 43812) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |