| NPI | 1861543969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL C RICCOBONI President 650-968-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 28609) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2012-11-01 |