| NPI | 1740684158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL TE RESPICIO Administrator 510-952-9936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48113) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 44172) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-10-14 |