| NPI | 1013435403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT DUPPER Owner/Senior Partner 909-558-6468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 036077) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2022-07-21 |