| NPI | 1972081545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE RYAN WHITELY President 530-885-6559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 59369) |
| Enumeration Date | 2018-08-05 |
| Last Update Date | 2021-12-23 |