| NPI | 1689894198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R. GLENN KITASOE Dentist 650-323-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 29329) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2015-11-23 |