| NPI | 1023227337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GABRIEL SCALAS Partner 714-827-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 47559) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 19360) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |