| NPI | 1588087597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN EVERHART Co Owner 916-939-9912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57768) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 50068) |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2014-01-27 |