| NPI | 1659415743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX R. MCDONALD Owner 510-832-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 42068) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2011-02-16 |