| NPI | 1962894170 |
|---|---|
| Doing Business As | PALM DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DAVID PARK Director 209-667-2254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 53724) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: CA 53191) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 57684) | |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2015-02-26 |