NPI | 1679039960 |
---|---|
Doing Business As | LAND PARK MODERN DENTISTRY DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | REYMOND C. BAUTISTA Owner 916-550-9429 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-02-12 |
Last Update Date | 2022-08-05 |