| NPI | 1710029442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD M. MIKOWICZ President 805-736-6571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 27458) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |