| NPI | 1992946495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY STEPHEN GORMAN Owner, Dentist 559-449-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 46809) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2021-03-15 |