NPI | 1619169521 |
---|---|
Entity Type | Organization |
Authorized Contact | DONNA J GERVASE Insurance Coordinator 530-223-1811 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 19525) |
Enumeration Date | 2007-08-14 |
Last Update Date | 2008-03-25 |