NPI | 1720227812 |
---|---|
Former Legal Business Name | RUSSELL C. HOLPUCH DDS, INC |
Entity Type | Organization |
Authorized Contact | ERIC M. BLASINGAME President/ Periodontist 530-241-3302 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics |
Enumeration Date | 2009-02-12 |
Last Update Date | 2019-12-20 |