| NPI | 1760511448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M. KELLEY Member 831-422-5832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 42924) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |