| NPI | 1730771353 |
|---|---|
| Doing Business As | GREENHAVEN FAMILY DENTAL LLC |
| Entity Type | Organization |
| Authorized Contact | JEROME PIELAGO Managing Dentist/Owner 916-412-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2021-02-04 |