| NPI | 1992918650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY BURGESS Orthodontist 650-365-8982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 17247) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |