| NPI | 1639544885 |
|---|---|
| Doing Business As | ABC DENTAL |
| Entity Type | Organization |
| Authorized Contact | LUIS CARLOS ANDREWS President/Dentist 209-725-2980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 49269) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 49269) |
| 1223G0001X Dentist, General Practice (Licence: CA 49269) | |
| Enumeration Date | 2015-12-13 |
| Last Update Date | 2017-08-08 |