| NPI | 1790474880 |
|---|---|
| Doing Business As | ISLAND DENTAL |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS GEORGE GOULTAS CEO 650-703-7451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2023-05-04 |