| NPI | 1962878033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERWIN DIAZ Office Manager 916-480-0522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 44669) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2015-08-12 |