| NPI | 1659030922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE R SANFORD Dentist/Owner 510-914-9665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2023-03-28 |