| NPI | 1912523234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANNA CHARLIE Dentist/President 925-895-5268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |