| NPI | 1588197156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX ANTIPOV Owner/Dentist 916-419-9939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 50724) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |