| NPI | 1790666170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY LAU Partner 415-376-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality | |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2025-09-11 |
| Last Update Date | 2025-09-16 |