| NPI | 1851476766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME VICTORES EVANGELISTA Dentist 510-887-6835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 37103) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |