| NPI | 1588269583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAN KALIKA President 916-297-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 122300000X Dentist |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2022-01-13 |