| NPI | 1851698740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD EVANS JOHNSON Owner 559-431-6626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 22814) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA 22814) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2012-02-20 |