| NPI | 1043377856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON MOSES President 949-364-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 21174) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |