| NPI | 1972574960 |
|---|---|
| Doing Business As | NORTHBANK DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | GARY W. COOPER Shareholder/Director 805-658-1577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 26831) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 50370) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-08-22 |