| NPI | 1841183944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEN SASO Business Manager 916-479-3432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-07-01 |