| NPI | 1649741190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MICHAEL YELLICH President 408-858-3051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2019-01-22 |