| NPI | 1598879538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN GAVIN MCCLURE President 831-426-1343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 38446) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |