| NPI | 1881844660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDELL P FUDGEN Dentist/Owner 510-465-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 22883) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2008-09-29 |