| NPI | 1679666895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAEDH S ALHWADI Managing Doctor 209-725-0905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 51080) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 48217) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |