| NPI | 1922790575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM SELMER Owner 888-970-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-23 |