| NPI | 1699127209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHOEBE-ELYN E MONTEMAYOR President 209-814-3645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 62549) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |