| NPI | 1962693663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY R NELSON Dentist 415-383-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 27624) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 27624) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |