| NPI | 1033595996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER ERIC HAGEN President 714-287-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 32842) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |