| NPI | 1720186125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERDINAND RONDILLA TUNGOL Chief Executive Officer Dentist 916-481-3930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 40125) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-03-23 |