NPI | 1942728241 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURA DAVID ELLEFSON Dentist 707-527-0363 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA DDS100710) |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2017-09-07 |
Last Update Date | 2017-09-07 |