| NPI | 1770789810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISLENA N THRASHER Office Manager 209-835-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43850) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |