| NPI | 1851402945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARK BAYLESS Owner 831-375-9232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 31564) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-09-24 |