| NPI | 1760594642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHON EVERETT LEE President 650-574-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 44730) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 44730) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 44730) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-11 |