| NPI | 1760785778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLANCA CASILLAS Vice President 925-300-3992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2014-10-24 |