| NPI | 1629682901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY K UENO Owner/CEO 408-402-2159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-04 |