| NPI | 1912571027 | 
|---|---|
| Doing Business As | A STREET DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | BLAKE K ANDERSON Doctor/Owner 916-765-7036 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental | 
| Enumeration Date | 2021-05-14 | 
| Last Update Date | 2021-05-14 |