| NPI | 1720133796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVRIL MAY ALTMAN Insurance Coordinator 707-427-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 48710) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 28479) |
| 1223G0001X Dentist, General Practice (Licence: CA 27964) | |
| 1223G0001X Dentist, General Practice (Licence: CA 30117) | |
| 1223G0001X Dentist, General Practice (Licence: CA 51677) | |
| 1223P0300X Dentist, Periodontics (Licence: CA 49443) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 19300) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 45580) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |