NPI | 1962609529 |
---|---|
Entity Type | Organization |
Authorized Contact | JON E. HOLLISTER Dentist Owner 805-543-6963 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 28328) |
Enumeration Date | 2007-06-28 |
Last Update Date | 2020-08-22 |