| NPI | 1952528671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SORENSEN President 559-447-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 46690) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2009-12-08 |