| NPI | 1982843033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLAS S VEACO Sole Owner/President 209-951-9045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 00G678190) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2018-06-21 |