| NPI | 1043332919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD B QUAN President 949-954-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 33740) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 30578) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |