| NPI | 1780860791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE ROBERT BURBACH Owner 805-466-3328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 28846) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2008-01-21 |