| NPI | 1992714729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHARI NELSON President 916-427-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47762) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |