| NPI | 1962630095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RANDOLPH PARKER President 209-722-3958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 18743) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-26 |