| NPI | 1619539384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB D. WEISSICH Owner Doctor 559-431-9104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2025-06-16 |