| NPI | 1619313822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD CORRIVEAU General Dentist 831-373-3068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41718) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |