| NPI | 1669647418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R. TRENT TORGERSEN Doctor 805-527-4470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DJ036205) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |