| NPI | 1922513811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN CASTILLO Manager 916-781-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57611) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-14 |