| NPI | 1851499412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN TIN Managing Dentist 415-682-2415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA B37744) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |