| NPI | 1912194242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE MICHELLE GONZALES Office Manager 805-643-5026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 42163) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |