| NPI | 1801255914 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | ROJELIO A MANCIAS Owner/Dentist 831-775-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 35142) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |