| NPI | 1700305802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE CASTILLO Secretary 559-221-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 45659) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2018-03-17 |