| NPI | 1902216732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW RON ANDERSON President 707-526-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 61202) |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2014-05-01 |