| NPI | 1043244056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JING CHEN Dentist 909-623-4435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 49289) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 52137) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-07-30 |