| NPI | 1740069459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANESS SMITH Owner/Employee 530-218-4292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2023-09-22 |