| NPI | 1801186556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHAUN CREDILLE Registered Dental Assistant 559-325-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: CA 75261) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |