| NPI | 1750984415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAGE A HUDSON Owner 916-877-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2020-11-17 |