| NPI | 1972988848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRNA GRACE SERRANO HILO General Dentist 408-727-0722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA B40610) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |