| NPI | 1710189469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN DARVIN FENDERSON President 707-258-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 20852) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |