| NPI | 1770701476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY R. SORENSEN Pres 559-447-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 20944) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2019-10-24 |