| NPI | 1831243104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY B WONG President And CEO 510-818-1891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 51156) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |