| NPI | 1740040682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DOANE Doctor 805-450-7329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-19 |