| NPI | 1922421379 |
|---|---|
| Doing Business As | HAWKEYE FAMILY DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | GLADYS KWAMBOKA GESICHO Director 209-632-2082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 46801) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2015-06-05 |