| NPI | 1629946504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLIN PARKINSON Member 916-502-5526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-10-23 |
| Last Update Date | 2025-10-23 |