| NPI | 1770688517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS REED BALES Orthodontist/Owner 415-897-3141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 24429) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |