| NPI | 1649521097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN W WARD Owner 831-728-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59615) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 59615) |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2012-09-25 |