| NPI | 1912746439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVON M KUTANOVSKI Owner Dentist 925-596-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-05-23 |
| Last Update Date | 2024-05-23 |