| NPI | 1679744239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA KRISTIANTO Manager 831-444-0882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA CA37441) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-03-21 |