| NPI | 1821611971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY Y TSUTSUI Authorized Official 559-287-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2020-05-24 |
| Last Update Date | 2020-05-24 |