| NPI | 1891185526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL DON HOMER Corporate Officer/ Dentist 916-363-9171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 32428) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 58930) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |