| NPI | 1730578063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL HERNANDEZ Office Manager 408-424-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: CA 76347) |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-01-09 |