| NPI | 1972924090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC L AXELRODE Owner 707-643-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 45640) |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2013-12-16 |