| NPI | 1679797930 |
|---|---|
| Doing Business As | PEDIATRIC DENTISTRY OF LOS ALTOS |
| Entity Type | Organization |
| Authorized Contact | JAMES KELLY Dentist 650-948-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 30395) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 38101) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 21718) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |