| NPI | 1881604494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIAN LUNDGREN-KOSZEGHY Periodontist 650-326-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: CA 51967) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 51967) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |