| NPI | 1679792592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ORR Business Manager 707-462-0413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 27582) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |