| NPI | 1659499481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON BRUNICK Owner 805-544-1941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 26302) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 49202) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |