| NPI | 1710317482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY CLIFTON Dental Hygienist 916-899-9665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR H5544) |
| Enumeration Date | 2013-11-17 |
| Last Update Date | 2013-11-17 |