| NPI | 1922686161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN E TUINEI Credentialing Manager 888-808-4513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-07-23 |