| NPI | 1902347537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAGAN TAPALTSYAN CEO 707-448-6252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 61666) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |