| NPI | 1629565338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL MARTINE WALTER Executive Director 408-315-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| 126800000X Dental Assistant | |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |