| NPI | 1881082329 |
|---|---|
| Other Name | LIFELONG DENTAL VAN |
| Entity Type | Organization |
| Authorized Contact | MARTIN LYNCH Chief Executive Officer 510-981-4123 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-01-07 |