| NPI | 1033362215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LALISA YAOWARATTANA Owner 909-825-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52133) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2009-12-23 |