| NPI | 1942590534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK T. WEISER Owner 805-899-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 28406) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2011-08-03 |