NPI | 1972908051 |
---|---|
Entity Type | Organization |
Authorized Contact | JARED G DANIELSON President 916-230-8837 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 52846) |
Enumeration Date | 2014-10-31 |
Last Update Date | 2014-10-31 |