| NPI | 1609276872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA H. COSTA Dentist/Owner 408-774-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 47733) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2014-08-25 |