| NPI | 1821487075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN DESTLER Dentist/Owner 805-499-1253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 41396) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |