| NPI | 1740795657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN CASTILLO Manager 916-781-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 48036) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-15 |