| NPI | 1598958183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE REYNOLDS WALSETH Corporation 805-963-0663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 22859) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |