| NPI | 1760607196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH TERRY PRATT Owner Doctor 510-522-7010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA D20716) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |