NPI | 1912347212 |
---|---|
Doing Business As | SURFSIDE KIDS DENTAL |
Entity Type | Organization |
Authorized Contact | TIMOTHY LYONS President 916-442-7873 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2013-07-01 |
Last Update Date | 2016-02-08 |